ORIGINAL ARTICLE   

Minerva Ortopedica e Traumatologica 2019 December;70(4):177-80

DOI: 10.23736/S0394-3410.19.03942-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Reduction maneuver and intra-articular fragments in acetabular fractures associated with posterior dislocation

Alessandro APRATO ✉, Luca TOLOSANO, Danilo CASASOLA, Marco FAVUTO, Kristijan ZOCCOLA, Gabriele COMINETTI, Alessandro MASSÈ

University of Turin, Turin, Italy

BACKGROUND: Literature is poor about the reduction maneuver in acetabular fracture-dislocation. Aim of this study is evaluating if the reduction maneuver increases the probability of interposing fragments inside the joint.
METHODS: Data regarding diagnosis, reduction in emergency room, time from trauma to surgery, type of surgery, duration of the surgical procedure, associated lesions, duration of hospitalization before and after surgery were collected. The X-ray images were studied for intra-articular fragments searching. Patient were also interviewed and data about Merle d’Aubignè-Postel score and subsequent hip arthroplasty were collected.
RESULTS: Patients who underwent a hip reduction maneuver, received a total hip arthroplasty (THA) in 15.63% of cases, while those who did not, underwent a THA implant in 25.71% of the cases. There was no correlation between hip reduction maneuver and the risk of THA implant (P=0.310). Among patients whose dislocation was reduced preoperatively, intra-articular fragments were found in 25% of cases, while the percentage of intra-articular fragments in those who were not reduced was 14.29%. No statistically significant association was found between the two groups (P=0.268).
CONCLUSIONS: Our study suggests that preoperative reduction of hip displacement it is not correlated with an increased risk of intra-articular fragments formation and then it can be considered as a safe procedure in patients with dislocations of the hip and posterior acetabula fracture. Moreover, the likelihood of a subsequent THA implant appears to be lower in patients who underwent narcosis reduction in the preoperative period compared to patients reduced directly during the definitive intervention.

KEY WORDS: Bone fractures; Hip replacement arthroplasty; Femur head necrosis