title: Long-Term Survival of the Native Hip After a Minimally Displaced, Nonoperatively Treated Acetabular Fracture.
abstract: BACKGROUND
  Few studies have evaluated the long-term results for nonoperatively treated acetabular fractures. The purpose of this study was to describe the long-term survival of the native acetabulum as well as the clinical and radiographic outcome for patients with nonoperatively treated acetabular fractures.
  
  
  METHODS
  All patients with acetabular fractures are prospectively registered in our acetabular fracture database and followed up at regular intervals for up to 20 years. We identified 236 patients (237 fractures) who had been treated nonoperatively between 1994 and 2004; 51 patients with incomplete data were excluded. For the survival analysis, 186 fractures with an average follow-up of 9 years (range, 1 to 20 years) were included. For the long-term clinical outcome, 104 patients with an average follow-up of 12.1 years (range, 9 to 20 years) were included.
  
  
  RESULTS
  The 10-year survival of the native hips was 94% (111 hips were at risk). Eighty-nine percent of the patients had a good or excellent Harris hip score, and 88% had a good or excellent Merle d'Aubigné and Postel score. The most important negative predictor for clinical outcome and survival of the hip was a fracture step-off of ≥2 mm measured in the obturator oblique radiograph.
  
  
  CONCLUSIONS
  Nonoperative treatment of minimally displaced acetabular fractures yields good to excellent long-term results. For patients with a questionable indication for fracture surgery, oblique radiographs (Judet views) are a helpful tool in the decision-making process, as a fracture step-off of ≥2 mm is a strong predictor for a poor clinical and radiographic result at 10 years.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Orthopaedic Department, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway John.Clarke-Jenssen@ous-hf.no.
authors.forename: John
authors.initials: J
authors.lastname: Clarke-Jenssen
authors.affiliation: Orthopaedic Department, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Annette K B
authors.initials: AK
authors.lastname: Wikerøy
authors.affiliation: Orthopaedic Department, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Olav
authors.initials: O
authors.lastname: Røise
authors.affiliation: Orthopaedic Department, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
authors.forename: Stein Arne
authors.initials: SA
authors.lastname: Øvre
authors.affiliation: Orthopaedic Department, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Madsen
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult