PURPOSE To evaluate the usefulness of wire fixation in displaced acetabular fractures. MATERIALS AND METHODS From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases. RESULTS We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases. CONCLUSION The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.
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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park Hip & Pelvis.2011; 23(2): 131. CrossRef
PURPOSE To analysis clinical and radiological results of operative treatment of displaced acetabular fractures and establish the guideline for the operative treatment of displaced acetabular fracture with the analysis of the clinical and radiological results. MATERIALS AND METHODS A clinical analysis was performed on 36 patients with displaced acetabular fractures who had been operated on and followed for minimum 1 year period from January 1993 to December 1998. Clinical outcome was analyzed clinically by Harris hip scoring system and radiologically by Matta's roentgenographic grading system. RESULTS According to Letournel's classification, we had 25 elementary fractures(69%) and 12 associated fracture(31%). Among the elementary fractures, the posterior wall fracture was the most common type(17 cases, 47%) and both column fracture was the most common type among associated fractures(5 cases, 11%).
Surgical approaches were 22 Kocher-Langenbeck, 8 extended iliofemoral, 3 triradiate transtrochanteric, 3 ilioinguinal. The mean duration of follow up after the operation was 2.2 years (range, 1 to 7 years). Among thirty six patients who had followed up more than one year, the satisfactory results were achieved in 27 cases (75%) on clinical grade and 26 cases (72%) on radiographic grade. The complications were developed in 20 cases out of 36 cases including posttraumatic arthritis 7 cases, heterotopic ossification 4 cases. CONCLUSION In the majority of the displaced acetabular fractures, accurate open reduction and internal fixation was recommended. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result according to our study. Therefore in the surgical treatment of the acetabuluar fractures, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixation device.
Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. The results had been proved to be successful after anatomical reduction and stable internal fixation. The purpose of this study is to analyze the clinical results and complications of open reduction of the displaced acetabular fractures to minimize the complications, and to present suggestions for the treatment of these fractures. We reviewed our experience with 23 displaced acetabular fractures which had been treated by open reduction to evaluate the clinical results and complications.
The results were as follows; 1. The most common type of elementary fractures was posterior wall fractures according to Letournel's classification. 2. Excellent or good results were obtained in 88% among the satisfactory reduction group, and it means that accurate reduction was the most reliable factors contributing to successful clinical outcomes. 3. Complications were 1 deep infection, 2 ectopic bone formation, 1 intraarticular hardware, and 1 chondrolysis. 4. In the treatment of displaced acetabular fractures, careful initial assessment using radiograph, angiogram and 3-D CT, appropriate selection of surgical approach and accurate surgical clinical outcome and minimize the complication rate.