Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the acetabulum.
Twenty-four patients underwent attempted closed or limited open reduction of displaced acetabular fractures. If reduction was successful, the fractures were stabilized with percutaneous screws. Group 1 was composed of elderly patients with complex fractures and radiographic findings that were felt to be predictive of post-traumatic arthritis. In these patients, percutaneous screw fixation was used to improve fracture anatomy, allow mobilization and total hip replacement later, if necessary. In group 1, anatomical reduction was not felt to be a necessity. Group 2 was composed of young patients with simple fracture types. For group 2, anatomical reduction was the goal. In 23/24 patients, closed or limited open reduction was successful. In group 1, maximum displacement averaged 10 mm preoperatively, 3 mm postoperatively. In group 2, maximum displacement averaged 7 mm preoperatively, 1 mm postoperatively. One elderly patient was lost to follow-up and one died, leaving 21 patients with an average follow-up of 12 months. All the fractures healed. One patient had a transient femoral nerve palsy, and two elderly patients had minor losses of reduction due to unprotected ambulation after surgery. Five of the elderly patients have gone on to total hip arthroplasty. The average Harris Hip scores in groups 1 and 2 were 85 and 96, respectively.
Starr
A J
AJ
Department of Orthopaedic Surgery, University of Texas Southwestern Medical School, Dallas, USA. adam.starr@utsouthwestern.edu
Jones
A L
AL
Reinert
C M
CM
Borer
D S
DS
D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000209:etiology / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D020428:Femoral Neuropathy / Q000209:etiology; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012075:Remission, Spontaneous; D016896:Treatment Outcome