PURPOSE The purpose of operative treatment in acetabular fracture is to restore anatomically the disrupted joint surface and prevent post-traumatic arthritis. We analysed the relationship between the types of the fracture, its location, reduction state with the development of post-traumatic arthritis and hip joint function in postoperative period. METHOD & MATERIAL: A clinical analysis was performed on 14 patients, excluding patients with anterior & posterior wall fracture, with displaced acetabular fracture who had been treated by open reduction and internal fixation. All patients had been followed for minimum 1 year in our department from May 1989, to February 1999. RESULTS The type of acetabular fracture was not correlated statistically with posttraumatic arthritis and Harris hip score. The reduction state of acetabular fracture was significantly correlated with post-traumatic arthritis and Harris hip score. The antomic location of acetabular fracture was not correlated statistically with post-traumatic arthritis but correlated with Harris hip score. CONCLUSION Anatomic reduction is more significant factor in postoperative outcome of acetabular fracture than the type of fracture and the anatomic location of fracture.
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Concomitant ipsilateral fractures of the femoral neck and shaft are rare, and present diagnostic difficulties and complex choices as to treatment.
At the Department of Orthopedic surgery, Pusan National University Hospital, from April 1987 to June 1998, 18 cases of the concomitant ipsilateral fractures of the femoral neck and shaft had been treeated and followed up for 48.7 months in average (ranging from 12 months to 89 months). Initially one case of the femoral neck fracture was missed, which was a non-displaced fracture. Femoral reck fractures were treated with multiple screws or pins in all cases except two cases treated with recon struction nail. For the femoral shaft fractures, plate and screws were applied in 12 cases, Ender nails in three cases, reconstruction nail in two cases and skeletal traction in one case. Nonunion of femoral shaft fracture was developed in one case treated with skeletal fraction, metal loosening in one case treated with Ender nails, and limited motion of the knee in three cases which had knee injuries. But in our cases, avascular necrosis of femoral head and nonunion of the femoral neck and metal failure were not developed. The key factors of successful treatment for concomitant ipsilateral fractures of the femoral neck and shaft seemed to be careful evaluation of the associated hip injures in felnoral shaft fracture and early anatomical reduction and rigid fixation of fractures with early motion of joints.