Journal List > J Korean Soc Fract > v.7(2) > 1078173

Kim, Woo, Kim, Song, Kwon, and Park: Surgical treatment of Unstable Acetabular Fracture Clinical analysis of 28 cases with consideration of surgical problems and complications

Abstract

Authors reviewed total 28 cases of acetabular fracture with operative management followed up over 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications.
The overall results were as follows:
1. According to the classification by Judet and Letoumel(1974), 20 cases were elementary fractures and 8 cases were associated fractures. The posterior wall fractures were most common in 9 case.
2. Kocher-Langenbeck approach in 18 cases, ilioinguinal in 4 cases, iliofemoral in 4 cases and triradiate transtrochanteric approach in 2 cases were used.
3. The devices for internal fixation were as follows screw only in 8 cases. plate and screw in 14 cases, plate and screw with circumferential wiring In 4 cases, wire and staple only in 1 each case.
4. The early and late complications occurred postoperatively as follows : incomplete sciatic nerve palsy 2 cases, wound infection 2 cases as early complications and posttraumatic arthritis 6 cases. avascular necrofis of femoral head 2 cases, heterotropic ossification 1 case as late complications.
Two cases of sciatic nerve palsy were spontaneously recovered and 2 cases of wound infection were controlled by adequate drainage and antibiotic therapy. And then, the total hip arthroflasty were carried out for 2 cases of avascular necrosis of femoral head, and 6 cases of posttaumatic arthritis and 1 case of heterotopic ossification were under observation.
5. Postoperatively, the causes of inadequate reduction and insufficient fixation were radiographically analyzed with immediate]y and lastly checked plain films, of which causes in 9 cases were as follows : inappropriate approach for exposure in 4 cases, delayed operation due to major associated injury over 3 weeks in 3 cases and severe comminution in 2 cases.
As a result, we reached to put an emphasis on an importatnce of preoperative planning, including the evaluation of individual fracture personality, the choice of surgical approach and the method of internal fixation.

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