Comparison between clinical and radiologic outcome measures after reconstruction of acetabular fractures.
OBJECTIVE
To compare clinical and radiologic outcome measures in patients after reconstruction of acetabular fractures and to investigate whether an objective radiologic outcome could be used as a proxy for a clinical outcome.


METHODS
Follow-up survey with retrospective analysis of consecutive case records.


METHODS
Over a ten-year period, 201 consecutive patients had open reduction and internal fixation of acetabular fractures performed by a single surgeon. The outcome measures on 166 fractures were available for analysis when the twenty-six patients who were lost to follow-up and the fourteen patients who had salvage total hip replacement were excluded.


METHODS
The assessment of patients was performed by one of two independent assessors, who used the Merle d'Aubigné (1954) clinical outcome score and a radiologic score of degenerative hip disease (Matta, 1994).


RESULTS
Although the overall correlation between the clinical and radiologic outcome grades was good (r = 0.63, p < 0.001), their agreement (i.e., the prediction of a specific clinical outcome by a corresponding radiologic one) was poor (Kappa = 0.24). The authors found that the clinical scoring system was difficult to apply specifically to acetabular trauma in 29 percent of fractures because of complications related to associated injuries. When the individual Merle d'Aubigné scores for pain, range of motion, and walking were correlated with the radiologic score, it was found that the walking score had a significant association with the radiologic score and the pain and range of movement scores.


CONCLUSIONS
The Merle d'Aubigné score has shortcomings as an outcome measure for acetabular fractures. Our aim to use a radiologic outcome as a proxy for this clinical grading system was not realized, but we propose that the patient's walking ability could be used as an objective local outcome measurement.
Rice
J
J
The Meath & Adelaide Hospitals incorporating The National Childrens' Hospital, Tallaght, Dublin, Ireland.
Kaliszer
M
M
Dolan
M
M
Cox
M
M
Khan
H
H
McElwain
J P
JP
D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome