OUTCOME OF PRIMARY FIXATION OF TRAUMATIC ACETABULAR FRACTURES PRESENTING TO PRIVATE SECTOR HOSPITALS.

Abstract

Background and Objective: Traumatic acetabular fracture is a rare injury with high mortality, morbidity

and long recovery period. Incidence of acetabular fracture is 3 per 100000(0.003%) population. Surgical

management of acetabular fracture is a technical challenge needing high level of skills and vigilance because

of the complex anatomy and risk to surrounding structures. We aim to look at two surgical techniques for

fixation of acetabular fracture and their outcome in this study.

Methods: Between April 2018 and March 2023, we performed a retrospective analysis of rare acetabular

fractures at the department of Orthopedic Kazi hospital Lahore and Doctor's hospital and Medical Centre

Lahore. Record of total of 26 patients (15 males and 11 females) who were treated for acetabular fracture

fixation were analyzed. Among these 10 were treated with minimal invasive technique i.e. Close reduction

and per-cutaneous fixation as good reduction was achieved under image guidance and 16 patients had open

reduction and internal fixation (ORIF) with use of various recon plates, screws and wires.

Results: Record of all the patients who were followed up for 12 months was retrieved. Among all patients, the

clinical outcomes were recorded as excellent in 17 patients (65%), good in 5 (19%), fair in 2 (7.7%), and poor in 2

(7.7%), according to the modified Merle d'Aubigné-Postel score. The average modified Merle d'Aubigné-

Postel score was 15 ± 2.0 points (range, 10–18 points). The radiological healing was assessed according to the

Matta score [22] and were reported excellent in 15 patients (15/26, 57.6%), good in 7 (7/26, 26.8%), fair in 1

(1/26, 3.8%), and poor in 3 (3/26, 11.5%).

Conclusion: Our study shows comparable clinical outcome for acetabular fracture fixation using either

ORIF or CRPF technique. Right patient choice and good knowledge of anatomy is of paramount importance.