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Online ISSN 1827-1707
D’Amelio A., Nicodemo A., Favuto M., Schirò M., Violante E., Drogo N., Casale V., Massè A.
Department of Orthopedics and Traumatology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
Aim: Both-column acetabular fractures are often a real challenge for pelvic surgeon, as require demanding diagnostic skills and surgical techniques. In this work we analyze the data of our experience in the treatment of these fractures, evaluating clinical and radiological outcomes, and correlation with the most known prognostic factors.
Methods: Between 2002 and 2009, 48 both-column acetabular fractures have been surgically treated in two hospitals of the University of Turin. The average age at the time of trauma was 39 years, and women were 25%. Forty patients were treated with a single ilioinguinal approach, seven patients with a double approach, one patient straight with a THR on fracture. The clinical outcome was assessed with the modified Harris Hip Score, the radiological one according to Matta’s criteria.
Results: The average value of modified HHS was 89, 3%. The anatomical reductions were 47% and satisfactory long-term radiological results 67%. Some complications were recorded as heterotopic ossifications (2/48), one intraoperative gluteal artery injury, six cases of transient paresthesia of the femoral cutaneous nerve, one case of weakness in the area depending by the sciatic nerve. Six patients developed post-traumatic osteoarthritis. The quality of reduction was confirmed as the strongest prognostic factor.
Conclusion: The treatment of these fractures performed by a pelvic surgeon with an accurate reduction can avoid the incidence of post-traumatic osteoarthritis of the hip involved.