OUTCOME OF TWO COLUMN ACETABULAR FRACTURES TREATED OPERATIVELY THROUGH SINGLE POSTERIOR APPROACH

Authors

  • Muhammad Naeem ur Razaq HOD orthpaedic department Ayub Medical College
  • Muhammad Ayaz Khan Khyber Teaching Hospital, Peshawar-Pakistan
  • Abbas Ali Khyber Teaching Hospital, Peshawar-Pakistan

Abstract

Background: Involvement of both columns in acetabular fractures is a common presentation, these fractures create a challenging situation for the surgeons in terms of understanding the dimensions of osseous injury and selection of surgical approach. The study was done with an objective to evaluate the efficacy of single posterior approach for acetabular fractures involving both columns directly reducing the posterior wall and column and indirectly reducing the anterior column. Method: An evaluation of 25 adult patients 18 male and 7 female presenting in the accident and emergency department of Khyber Teaching Hospital from December 2013 to June 2015 having acetabular fracture involving both the anterior and posterior column were included in this case series study. All patients were operated within 8 days of injury by a single operating team. Exposing and reducing the posterior acetabular column through kockerlengenbeck approach did open reduction and internal fixation with reconstruction plate and cortical screws. Additional lag screw was used to stabilize anterior column after indirect reduction with confirmation through C- arm and digital palpation through the greater sciatic notch. Patients were followed up for 6 months and Harris Hip score was evaluated after the end of the follow up period and the result was analysed. Result: Majority of the patients 20 out of 25 had haris hip score more than 90 after 6 months of the operative management. Conclusion: It is suggested that acetabular that fractures involving both the acetabular columns in certain situations, may be managed by a single posterior approach as it is associated with good clinical outcome and involves lesser soft tissue complications.Keywords: Acetabular fracture; Management; Outcome; Two column acetabular fracture; Posterior approach 

Author Biography

Muhammad Naeem ur Razaq, HOD orthpaedic department Ayub Medical College

HOD orthpaedic  department Ayub Medical College

References

Letournal E. Acetabular fractures: classification and treatment. Clin Orhthop Relat Res 1980;(151):81–106.

Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach: a 10- year perspective. J Orthop Trauma 2006;20(1 Suppl):S20–9.

Ponsen KJ, joosse P, Schigt A, Goslings JC, Luitse JS. Internal fracture fixation sing the stoppa approach in pelvic ring and acetabular fractures: technical aspects and operative results. J Trauma 2006;61(3):662–7.

Giordano V, Pecegueiro do Amaral N, Franklin CE, Pallottino A, Pires E Albuquerque R, Giordano M. Fungtional outcome after operative treatment of displaced fractures of the acetabulum: a 12 – month to 5-year follow – up investigation. Eur J Trauma Emerg Surg 2007;33(5):520–7.

Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction: preliminary report. J Bone Joint Surg Am 1964;46:1615–46.

Giordano V, do Amaral NP, Pallottino A, Pires e Albuquerque R, Franklin CE, Labronici PJ. Operative treatment of transverse acetabular fracures: is it really necessary to fix both columns? Int J Med Sci 2009;6(4):192–9.

Kaempfe FA, Bone LB, Border JR. Open Reduction and internal fixation of acetabular fractures: Heterotopic ossification and other complications of treatment. J Orthop Trauma 1991;5(4):439–45.

Oh CW, Kim PT, Park BC, Kim SY, Kyung HS, Jeon IH, et al. Results after operative treatment of transverse acetabular fractures. J Orthop Sci 2006;11(5):478–84.

Griffin DB, Beaule PE, Matta JM. Safety and efficacy of the extended iliofemoral approach in the treatment of complex fracture of the acetabulum. J Bone Joint Surg Br 2005;87(10):1391–6.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51(4):737–55.

Downloads

Published

2016-12-01

Most read articles by the same author(s)