title: Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: Retrospective study of 414 patients over 10 years.
abstract: Epidemiological studies of acetabular fractures (AFs) are scarce and, to our knowledge, the most recent one from France, by Letournel and Judet, dates back to 1993. Studies have suggested a decrease in high-energy AFs contrasting with an increase in low-energy AFs due to the longer life expectancy. However, a French case-series study failed to confirm these data. We therefore conducted a 10-year retrospective study in a level-1 trauma centre to: (1) characterise the epidemiological profile of AF; (2) and to describe the treatment strategy.
  
  
  
  The epidemiological profile of AF in France is consonant with data from European case-series studies.
  
  
  
  All patients managed for AF between 2005 and 2014 were included in this single-centre retrospective study. All patients were re-evaluated at our centre or another facility 6 months after the fracture. The epidemiological data were compared in the three treatment groups: non-operative, open reduction and internal fixation (ORIF), and total hip arthroplasty (THA).
  
  
  
  Between 2005 and 2014, 414 patients were admitted for AF. Mean age was 49.4 years (range: 15-101 years). Treatment was non-operative in 231 (56%) older patients, most of whom had low-energy fractures involving the anterior wall. THA with or without acetabular reinforcement and screw-plate fixation was performed in 27 (7%) older patients, most of whom had posterior-wall fractures and experienced postoperative complications (26/27 patients, 96%). ORIF was used in 156 (38%) younger patients, most of whom had high-energy fractures of greater complexity.
  
  
  
  Our results reflect the current indications in AF management. The epidemiological characteristics in our population are comparable to those reported in the few recent European epidemiological studies. To our knowledge, this is the largest French epidemiological study since the landmark work by Letournel and Judet.
  
  
  
  Level IV, retrospective study.
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France; CNRS UMR 5525, laboratoire TIMC-IMAG, université Grenoble Alpes, Pavillon Taillefer, 38700 La Tronche, France. Electronic address: mboudissa@chu-grenoble.fr.
authors.forename: M
authors.initials: M
authors.lastname: Boudissa
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.
authors.forename: F
authors.initials: F
authors.lastname: Francony
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.
authors.forename: G
authors.initials: G
authors.lastname: Kerschbaumer
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.
authors.forename: S
authors.initials: S
authors.lastname: Ruatti
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.
authors.forename: M
authors.initials: M
authors.lastname: Milaire
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France; CNRS UMR 5525, laboratoire TIMC-IMAG, université Grenoble Alpes, Pavillon Taillefer, 38700 La Tronche, France.
authors.forename: P
authors.initials: P
authors.lastname: Merloz
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Nord, université Grenoble Alpes, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France; CNRS UMR 5525, laboratoire TIMC-IMAG, université Grenoble Alpes, Pavillon Taillefer, 38700 La Tronche, France.
authors.forename: J
authors.initials: J
authors.lastname: Tonetti
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000706:statistics & numerical data; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000453:epidemiology* / Q000601:surgery*; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000070799:Open Fracture Reduction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D014193:Trauma Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acetabular fracture; Arthroplasty; Epidemiology; French trauma centre; Internal fixation; Non-operative treatment