Functional and Radiological Outcome of Surgical Management of Acetabular Fractures

INTRODUCTION: Fractures of acetabulum are relatively uncommon, but because they involve major weight bearing joint in the lower extremity, they assume great clinical importance. Anatomic reduction and stable rigid internal fixation of the fracture, such that the femoral head is concentrically reduced under the weight bearing dome of the acetabulum, is the treatment goal for early mobilization and weight bearing. MATERIALS AND METHODS: 15 patients admitted with clinical and radiological diagnosis of acetabular fracture in Coimbatore Medical College Hospital from May 2016 to September 2018 were included in the study. They were operated through posterior, anterior or combined approaches and functional, radiological outcome was assessed during follow up. RESULTS: Satisfactory reduction was acheived in 73% (11 patients), as per Matta’s radiological criteria. According to Merle d’Aubigne score, Excellent to good functional outcome was attainted in 9 patients with only 1 patient having a poor result. There was a decreased mean functional score (14) in the fracture group with poor fracture reduction. Compliactions like AVN of femur head and sciatic nerve palsy was encountered with a 7% incidence. Associated posterior wall fracture had reduced the outcome score. CONCLUSION: Use of non-extensile approaches alone is sufficient to attain adequate fracture reduction with minimal possible complications. Every chance of anatomic reduction of fracture, rigid internal fixation and early mobilization should be done for better functional outcome which is not achievable by conservative means