title: Fracture of the acetabulum: a retrospective review of ninety-one patients treated at a single institution.
abstract: Acetabular fracture result in fairly good outcome after the anatomic reduction in the displaced fracture fragments and damaged joint structure, but some patients will inevitably suffer from hip joint problems during their courses after the insult. We retrospectively reviewed 91 patients with acetabular fractures to investigate the causes of clinical failure and relationship among the fracture types, selected treatment options and their courses. Ninety-one patients (73 men and 18 women) with an average age of 49 years (range 18-80) at the time of injury were followed up for an average of 8.6 years (range 2-18). Judet-Letournel classification of fracture type and Matta's rating regimen of functional and radiographic patient' assessment were conducted. Conservative treatment was provided in 20 patients, in which 19 attained excellent/good, and one fair clinical results. All achieved excellent/good radiographic outcome. Surgically treated patients (n = 71) with critical dislodgement of the fracture fragment showed that 64 (90%) attained excellent/good and 7 (10%) fair/poor clinical outcomes. Sixty-three (89%) attained excellent/good and 8 (11%) fair/poor postoperative radiographic outcome. Five patients with poor radiographic outcome after surgery subsequently required total hip arthroplasty, due to the development of hip joint osteoarthritis in 3 and femoral head avascular necrosis in 2. We conclude that displacement of the joint surface should be reduced to less than 3 mm in accordance with the selection of the most appropriate surgical approach for open reduction/fixation in each fracture type; however, comminuted fracture and avascular necrosis of the femoral head may be the cause of poor clinical results.
authors: Department of Orthopaedics and Rehabilitation Medicine, Fukui University Faculty of Medical Sciences, Matsuoka Shimoaizuki 23, Eiheiji, Fukui 910-1193, Japan.
authors: Kenzo
authors: K
authors: Uchida
authors: Yasuo
authors: Y
authors: Kokubo
authors: Takafumi
authors: T
authors: Yayama
authors: Hideaki
authors: H
authors: Nakajima
authors: Tsuyoshi
authors: T
authors: Miyazaki
authors: Kohei
authors: K
authors: Negoro
authors: Kenichi
authors: K
authors: Takeno
authors: Takeshi
authors: T
authors: Sawaguchi
authors: Shuji
authors: S
authors: Watanabe
authors: Daisuke
authors: D
authors: Sugita
authors: Naoto
authors: N
authors: Takeura
authors: Ai
authors: A
authors: Yoshida
authors: Hisatoshi
authors: H
authors: Baba
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult