Long-term outcome of conservatively managed displaced acetabular fractures.
BACKGROUND
The purpose of this study was to determine the long-term outcome of conservatively managed acetabular fractures involving the weight-bearing dome, which otherwise deserves an operative treatment.


METHODS
Thirty-two patients with displaced acetabular fractures (>3 mm displacement) involving the weight-bearing dome and not associated with unstable pelvic ring injuries met the inclusion criteria for this study with a minimum of 2 years of follow-up evaluation. They were assessed using the Merle de'Aubigne and Postel clinical scoring and Matta's radiologic scoring system. The mean duration of follow-up was 4.1 years (2-12 years).


RESULTS
The reducibility of acetabular fractures by conservative management stood at 18 of 32 (56.3%) synchronizing with 18 of 32 (56.3%) good to excellent clinical score. The mean clinical score was 14.25 +/- 3.41 of a total score of 18. In patients with good fracture reduction, good to excellent results were seen in 83.3% cases. The radiologic grade was good to excellent in 50% cases with good clinicoradiologic correlation (p = 0.0001).


CONCLUSIONS
Acetabular fractures involving the weight-bearing dome if reduced by closed means can be maintained by heavy lateral and longitudinal traction resulting in good clinicoradiologic outcome comparable with operative management.
Sen
Ramesh K
RK
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Veerappa
Lokesh A
LA
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult