SURGICAL TREATMENT OF POSTERIOR WALL ACETABULAR FRACTURE DISLOCATION: PREDECTION OF RISK FACTORS FOR FUTURE COMPLICATIONS; PROSPECTIVE STUDY

Abstract

Acetabular fractures are generally caused by high- energy trauma and associated injuries are frequent. Treatment of the entire patient should follow accepted Advanced Trauma Life Support (ATLS) protocol, with orthopedic management of the acetabular fracture appropriately integrated into the treatment plan. The purpose of this study was to show the results of operative fixation of posterior wall acetabular fracture dislocation and to predict the risk factors for future complications. A prospective study was done on 30 patients complaining from posterior wall acetabular fracture dislocation. Twenty eight cases were included in the study and 2 patients were excluded. The patients were treated at Al-Sadder Teaching Hospital, Orthopedic Sub department from February 2008-April 2014 with 2-5 years follow up. Patients were also followed up clinically and radiologically, early postoperatively, every 2 weeks for first 6 weeks and thereafter every 3 months for 2-3 years. The clinical assessment was based on the clinical scoring system based on Score of Merle D’Aubigne and postel. The mechanisms of fractures was usually due to major trauma, mainly occurred due to road traffic accident (12 cases, 42.8%), and followed by falling from height (8 cases, 21.4%). The majority of cases had associated injuries 17 cases (61.8%) and the main injuries were associated fractures (7 cases, 25%). There was no significant correlation between the time of surgery and the appearance of future complications. Radiological criteria for postoperative reduction were evaluated by 2 radiologists and qualities of reduction were correlated with the cases of associated complications which showed significant correlation between quality of reduction and appearance of future complications (P less than 0.05).