title: Outcome of alternative approach to displaced acetabular fractures.
abstract: BACKGROUND
  Anatomical reduction of displaced acetabular fracture is not without its' limitations and complications. This study is conducted to assess clinical and radiological outcomes as well as complications of treating displaced acetabular fractures with emphasis on anatomical reduction in weight-bearing area, mainly the posterior column, and imperfect reduction of the anterior column is acceptable. However, stability of both columns is mandatory.
  
  
  METHODS
  It was a retrospective study carried out in a Level 1 arthroplasty and trauma centre. 23 patients (17 males, 6 females) with average age of 50.1 years (range, 36-68 years) with displaced acetabular fracture treated with combined incisions and plate-cable systems were included. There were 3 elementary and 18 associated fractures according to Letournel classification. Average follow-up was 23.5 months (range, 12-38.7 months). Mean operation time was 160min (range: 75-320min). Functional scores were evaluated using Harris Hip Score (HHS) whilst reduction was assessed by Matta criteria. Any displacement of reduction, osteoarthritis, heterotopic ossification, and other complications was recorded.
  
  
  RESULTS
  65.2% (15/23) of the patients obtained excellent HHS and 21.7% (5/23) had good HHS. There were 12 anatomical, 6 imperfect, and 5 poor reductions. No displacement was recorded in final follow-up. Complications documented: three lateral femoral cutaneous nerve injuries, two conversions to total hip arthroplasty, three Brooker stage 1 heterotrophic ossification, one pulmonary embolism and one screw irritation. No incidence of wound breakdown, infection and radiological osteoarthritis was reported.
  
  
  CONCLUSIONS
  Imperfect reduction of the anterior column provided clinical outcomes that are as good as total anatomical reduction. This approach minimizes soft tissue damage and reduces perioperative morbidities.
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea.
authors.forename: K S
authors.initials: KS
authors.lastname: Park
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea; NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University Malaya, 59100 Kuala Lumpur, Malaysia.
authors.forename: C K
authors.initials: CK
authors.lastname: Chan
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea.
authors.forename: G W
authors.initials: GW
authors.lastname: Lee
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Ahn
authors.affiliation: Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea. Electronic address: tryoon@chonnam.ac.kr.
authors.forename: T R
authors.initials: TR
authors.lastname: Yoon
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Acetabular fracture; Acetabulum; Anatomical reduction; Anterior column; Cable; Double incision; Open reduction; Outcome; Plating; Posterior column