Introduction: acetabular fractures are considered to be the most complex among pelvic fractures, which impair the function of the hip joint and lead to disability in 35-88% of cases.
Material & Methods: The retrospective analysis included 62 patients with acetabular fractures of the posterior wall, who underwent surgical treatment in 2012-2017 with 5-year follow-up. Mean age of the patient was 39.5 years (range, 23-56), male 43, female 19. Dislocation of the femur was eliminated on the first day – in 48 patients (77%), on days 2-5 in 7 (11%), and later in 6 (10%) patients. Among all patients, post-traumatic neuropathy occurred in 5 (8%) cases. The timing of surgery was from 7 days to 6 weeks after initial injury.
Results: In 57 (92%) cases, anatomical reduction of the fragments was achieved, in 8 (13%) cases it was not possible to achieve anatomic reduction due to different reasons, which affected the final results of treatment. Post-traumatic arthritis after 1 year was diagnosed in 10 patients (16.1%), after 5 years - in 24 (38.7%). Femoral head AVN after 1 year was diagnosed in 9 (15%) patient, after 5 years - in 23 (37%). Functional results in Harris Hip Score: after 1 year - 82±16 points, after 5 years - 86±14 points.
Conclusions: The result of treatment is affected by anatomical reduction of the fracture, the timing of hip dislocation reduction, the duration of the surgery, damage of the cartilage of the femoral head, damage to the acetabular arch with the presence of impaction zones, the presence of free intraarticular fragments in the joint cavity. Foot dysfunction associated with damage to the sciatic nerve has a negative impact on the treatment outcome.
References: Vyrva O., Dmytro V. "Modern tendences in the treatment of acetabular fractures (literature review)." ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS 2 (2021): 83-91.
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