Conservative Management Vs Operative Management for Acetabular Fracture: A Comparative Analysis

Surgery for acetabular fractures is challenging due to challenging surgical access, challenging fracture anatomy, challenging anatomic reduction, challenging surgical complications, challenging functional outcomes, and challenging chondral damage. Acetabular fractures have a significant mortality and morbidity rate. Internal fixation is a fast developing method of treating these fractures with results that are comparable to those of conservative treatment. Displaced fractures are now typically treated with surgery. Perfect reduction is the aim of open reduction and internal fixation of an acetabular fracture. Our study compares the outcomes of non-operative and operative care for displaced acetabular fractures in the Indian population. Methods: We chose 50 patients for this retrospective investigation, of whom 25 received surgery and 25 did not, and who were all diagnosed with a displaced acetabular fracture. Since all patients underwent surgery more than a year after the fracture, we compared their functional results at the end of the year. We used the Merle D'Aubigne and Postel scoring system to evaluate the functional result at one year. These results were then compared between the two groups using a paired t-test. Results: In the operated group, we had 56% (14 patients) great results, 24% (6 patients) very good results, 4% (1 patient) decent results, 8% (2 patients) mediocre results, and 8% (2 patients) poor results. The non-operated group had outcomes of 16% (4 patients) that were excellent, 20% (5 patients) that were very good, 4% (1 patient) that were good, 16% (4 patients) that were moderate, and 44% (11 patients) that were poor. We split the outcomes of patients who underwent surgery and those who did not into two groups. Patients in the first group were those who had good or better results, and patients in the second group were those who had subpar results. With an odd ratio of 9.036 and a 95% coefficient interval between 3.966 and 20.588, the Fisher's exact test was employed to compare the two groups, and the results showed a statistically significant difference between the outcomes of the operated and non-operated groups. Conclusion: Compared to conservative care, displaced acetabular fractures treated with surgery fixation perform better in terms of functional outcome and post-treatment side effects