Results of 75 consecutive patients with an acetabular fracture.
From 1988 to 1991, 75 consecutive patients with an acetabular fracture were treated. Follow up was for a minimum of 2 years (average, 3 years; range, 2-5 years). Sixty five patients had a solitary acetabular fracture, and in 10 the acetabular fracture was associated with a pelvic fracture (52 men and 23 women; average age, 46 years; range, 17 to 99 years). Twenty four patients were treated nonoperatively (average age, 46 years; range, 12 to 99 years), and 51 underwent surgery (average age, 45 years; range, 17 to 92 years). The indications for surgery were: displacement of the fracture of > 2 mm; an intraarticular fragment interfering with joint movement; posterior instability of the joint with a luxating femoral head; insufficient roof arc; or to prepare the joint for total hip replacement. The patients were classified according to Letournel. Nonoperative treatment consisted of traction or nonweightbearing mobilization during an average period of 2 weeks. The surgical approaches used were: the Kocher-Langenbeck (22); the ilioinguinal (18); and the extended iliofemoral (4). More than 1 approach was used in 3 cases; external fixation was used in 4. All patients received prophylactic treatment of indomethacin. Six developed heterotopic ossification. Preoperatively, 6 patients had a paresis or paralysis from which 5 recovered. Pre- and postoperative nerve lesions occurred in 3 patients from which 2 recovered. One patient died perioperatively of pulmonary embolus. In 2 patients a collapse of the posterior wall resulted in a total hip replacement. The results were good to excellent according to the d'Aubigne scale in 76% of all patients.
de Ridder
V A
VA
Department of Traumatology, Westeinde Hospital, Den Haag, The Netherlands.
de Lange
S
S
Kingma
L
L
Hogervorst
M
M
D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control
D007213:Indomethacin