Publication:

Evaluation of the result of open reduction and internal fixation of transverse fracture of acetabulum by reconstruction plate and screws through Kocher-Langenbeck approach

Background Acetabular fracture occurs from high-velocity injury and affects young, economically productive populations. Previously, treatment was inadequate, leaving patients with incapacitating pain and limited movement. Proper management in our setup is needed to save lives and minimize long-term complications. This study evaluated the outcome of open reduction and internal fixation of transverse acetabular fractures.

Methods This prospective observational study was conducted at Dhaka Medical College Hospital from July 2017 to June 2019. A total of fifty patients with transverse fracture of acetabulum within 3 weeks of incidence were enrolled in this study. Radiological and functional outcomes were evaluated six months post-surgery using Matta's radiographic criteria and Merle d'Aubigne and Postel criteria. Effects of age, gender, hip dislocation, fracture displacement, reduction quality and trauma on surgery time were evaluated.

Results Mean age was 36.2±14.12 years. Male and female ratio was 48:2. Mean follow-up 8.5±1.7 months, range 6-12 months. According to Matta's criteria, 24 patients had excellent, 8 good and 18 fair radiological outcomes. Per Merle d'Aubigne and Postel criteria, 20 patients had excellent, 10 good, 2 fair and 18 poor functional outcomes. Overall, 38 patients (76%) showed satisfactory and 12 patients (24%) unsatisfactory outcomes. Heterotrophic ossification occurred in 1(4.0%) patient. 20 patients achieved anatomic (0, 1 mm) reduction, 3 achieved imperfect (2,3 mm) reduction and 2 achieved poor (>3 mm) reduction.

Conclusions Open reduction and internal fixation of transverse acetabular fracture is a satisfactory treatment method.