Long-term results in surgically treated acetabular fractures through the posterior approaches.
BACKGROUND
The long-term results of surgically treated displaced acetabular fractures using the posterior approaches and the possible role of the greater trochanteric osteotomy in the development of heterotopic ossification (HO) are still somehow controversial despite extensive publications.


METHODS
Seventy-five patients with an acetabular fracture and displacement of at least 3 mm were surgically treated during a 6-year period. The duration of the follow-up was from 10 to 15 years, with a mean of 12.5 years.


RESULTS
The over-all satisfactory clinical result, grouping together the excellent and good results, was 80%. There was a good correlation between clinical and radiologic results. The most common complication was HO, observed in 19 patients (25.3%). The extended iliofemoral approach had the greater incidence of HO (40%), whereas the least was observed in the Kocher-Langenbeck approach with osteotomy of the greater trochanter (21.4%). Moreover, posttraumatic osteoarthrosis was observed in eight patients (10.7%) and osteonecrosis of the femoral head in six (8%).


CONCLUSIONS
Surgical treatment of the acetabular fractures aiming at anatomic reduction of the acetabulum and congruency with the femoral head is the prerequisite for a favorable functional outcome in the long term. In most cases, the Kocher-Langenbeck approach is adequate. Trochanteric osteotomy is indicated only for fractures extending toward the anrerior column and this facilitates exposure, anatomic reduction, and fixation. No statistically significant difference was found between the surgical approach and heterotopic bone formation.
Triantaphillopoulos
Panagiotis G
PG
Orthopaedic Department of Patras University, Patras, Greece.
Panagiotis
Triantaphillopoulos
T
Panagiotopoulos
Elias Christos
EC
Elias
Panagiotopoulos
P
Mousafiris
Constantinos
C
Constantinos
Mousafiris
M
Tyllianakis
Minos
M
Minos
Tyllianakis
T
Dimakopoulos
Panagiotis
P
Panagiotis
Dimacopoulos
D
Lambiris
Elias E
EE
Elias
Lambiris
L
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006115:Greece / Q000453:epidemiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome