Open reduction and internal fixation of acetabulum fractures: does timing of surgery affect blood loss and OR time?
OBJECTIVE
The purpose of this study was to investigate the timing of surgical intervention for fractures of the acetabulum and its influence on perioperative factors.


METHODS
Retrospective review.


METHODS
Level I trauma center.


METHODS
Two hundred eighty-eight consecutive patients who sustained either posterior wall (PW), associated both column (ABC), or anterior column posterior hemitransverse (ACPHT) acetabulum fractures were included in the study.


METHODS
One hundred seventy-six PW fractures were treated through a Kocher-Langenbeck approach, and 112 ABC/ACPHT fractures were treated through an anterior intrapelvic approach.


METHODS
Estimated blood loss (EBL), operative time.


RESULTS
EBL (800 vs. 400 mL), operative time (270 vs.154 minutes), and hospital stay (11 vs. 7 days) were greater for the ABC/ACPHT fractures compared with the PW fractures. When comparing early (≤48 hours) versus late (>48 hours) treatment of PW fractures, there was no difference in EBL (400 vs. 400 mL, P = 0.37) or operative time (150 vs. 156 minutes, P = 0.50). In comparison of early versus late treatment of ABC/ACPHT fractures, no significant difference was noted in EBL (725 vs. 800 mL, P = 0.30) or operative time (258.5 vs. 272 minutes, P = 0.21).


CONCLUSIONS
We found no advantage or disadvantage in terms of EBL or operative time for early (≤48 hours) versus late (>48 hours) fixation for either PW or ABC/ACPHT acetabular fractures.


METHODS
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH.
Steven K
SK
Dailey
Michael T
MT
Archdeacon
D000077:Acetabulum / Q000293:injuries / Q000601:surgery*; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013997:Time Factors