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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2003 October;54(5):403-10
Functional outcome of the operatively treated unstable complex injuries of the pelvis and the acetabulum
Katonis P. 1, Aligizakis A. 1, Sapkas G. 2, Galanakis I. 1, Korovesis P. 3, Hadjipavlou A. 1
1 Department of Orthopaedics University of Crete Medical School, Heraklion, Greece
2 Department of Orthopaedics Agios Andreas Hospital, Patra, Greece
3 Department of Orthopaedics University of Athens Medical School, Athens, Greece
Aim. The purpose of this prospective study is to assess the functional outcome of operatively treated unstable complex injuries of the pelvis and the acetabulum.
Methods. A total of 20 unstable complex injuries of the pelvis and the acetabulum underwent surgery in our Department over the period 1994-2000. Pelvic injuries were classified according to Tile and pre- and postoperative anteroposterior, inlet and outlet X-rays, in conjunction with CT scans were also utilised. The acetabular fractures were classified according to the Judet and Letournel classification; and anteroposterior pelvis views and Judet oblique X-rays, and 3D CT-scans were taken. Associated injuries were present in 7 out of the 20 patients.
Results. The follow-up period was 4 years for all the patients. Clinical and radiological evaluation was done at 3 months, 6 months, 1 year, and every year subsequently. The pelvis functional scoring was 27 points. The acetabular clinical results were in 20% of the cases excellent, 55% good, 20% fair, 5% poor, and the radiological results were in 40% excellent, 40% good, 15% fair, and 5% poor. The complication rate was 40%. The overall functional outcome of these complex injuries was satisfactory in 75% of the cases.
Conclusion. Emergency treatment for such patients requires a multidisciplinary team approach, including a trauma surgeon, orthopaedist, and interventional radiologist. The functional outcome of this kind of complex injury correlates closely to treatment methods and the orthopaedic surgeon’s experience. The prognosis depends mostly on the effective treatment of the acetabular fracture and associated injuries.