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Outcome of Operatively Treated Anterior Column Fracture of the Acetabulum- A Short term Prospective Cohort Study

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Author(s): P. K. Sancheti, Atul Patil, A.K. Shyam, Kailash Patil,Milind Merchant.

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 6;
Issue: 4;
Date: 2009;
Original page

Keywords: anterior acetabulum fractures | surgical management

ABSTRACT
Background: Treatment of the anterior acetabular fractures is known to have worse results than other fracture types. The operative results of the anterior acetabular fracture, however, have not been well documented and the literature concerning them is sparse. To determine the results of operative treatment for anterior column acetabular fractures, we did a prospective cohort study of 17 cases of anterior column fractures. Methods: A total of 17 patients had anterior column fractures, with an average follow-up period of 24 months; 1 anterior wall, 3 anterior column, 8 anterior fracture with posterior hemitransverse and 5 anterior wall with anterior column fractures. There were 15 men and 2 women, with a mean age of 36.6 years. The surgical approaches used were ilioinguinal approach used in 14 cases and extended iliofemoral approach used in 3 patients with delayed presentation. Postoperative radiographic results were evaluated by Matta’s criteria. Final clinical results were evaluated by a Harris Hip scoring system Results: All of the fractures healed. Postoperative radiology revealed 8 cases of anatomical reduction, 8 cases of imperfect reduction, and 1 cases of poor reduction. According to the clinical results, 16 patients had satisfactory results (11 excellent, 5 good), and 1 had poor result. Regarding complications, there were 1 case of traumatic osteoarthrosis and 1 of heterotopic ossification. The patients with an anatomical reduction had a higher satisfactory result rate. Poor reduction intra operatively seemed to have an adverse influence on the postoperative radiologic result as well as a correlation with the development of traumatic arthritis. Conclusion: Anterior acetabular fractures have comparatively higher rates of imperfect reduction and may have a tendency toward traumatic osteoarthritis; however a longer follow up study is essential.
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