Chelsea Snykers (Leuven / BE), Michiel Herteleer (Leuven / BE), Paul Vanderschot (Leuven / BE)
Introduction: This study aimed to analyze the epidemiology, radiographical and functional outcomes of patients who were surgically treated in our center over a 10-year period.
Methods: We performed a retrospective chart review of all patients who were surgically treated for an acetabular fracture from 2011 to 2020. Demographic data, type of surgery and outcome after surgery were analyzed using descriptive statistics.
Results: Between 2011 and 2020, 202 patients (159 male and 43 female) with an average age of 55 years (18.02 SD) were treated for acetabular fractures. Patient health status was categorised as follows: 27% ASA 1, 37% ASA 2, 24% ASA 3, 14% ASA 4, and 6% unknown. The fracture types were categorized into 53,5% elementary (27 PW, 8 PC, 18 AW, 42 AC, 12 TV) and 46,5% associated types (15 PW+PC, 18 TV+PW, 7 TT, 31 AC+PHT, 22 BC). The mechanisms of injury included 45 MVA, 19 MBA, 29 FH, 35 oHET, 60 LE and 14 cases of unknown origin. The median time from admission to surgery was 70 hours (Q1 22- Q3 137). Of all cases, 94 used an anterior approach (28 Ilioinguinal, 3 Stoppa, 64 Pararectus), 82 a posterior approach (74 Kocher-Langenbeck, 18 Triradiate), 10 a percutaneous fixation, and 11 combined. The reduction quality immediately postoperatively as defined by Matta, was anatomical in 46%, imperfect in 26.3%, bad in 12% and unknown in 16%. After one year, using the Rommens and Hessmann criteria, outcomes were excellent in 19%, good in 27%, moderate in 16%, poor in 4%, and unknown in 34%. Thirty-four patients required secondary THR after a mean time of 634 days (SD 529), with a 2-year survival rate of 93.3%.
Conclusion: Men are more commonly affected than women, with over a quarter of injuries resulting from low-energy traumas. The functional outcome after one year and the two-year survival rates highlight the importance of adequate treatment for severe injuries in both young and older patients. Age should not be a treshold to perform surgery in these patients.
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