Predictors of postoperative outcome for acetabular fractures

Background: The outcomes of surgically treated acetabular fractures are dependent on many factors. The purpose of this retrospective study is to evaluate these factors in a group of patients operated on by a single surgeon in one institute. Methods: One hundred and eighteen patients, treated surgically for their displaced acetabular fracture and who had completed two years follow-up, were evaluated clinically with Modified Postel Merle d'Aubigne score and radiologically with Matta's radiological outcome grading. The effect of age (<= 55 or >55 years), gender, fracture displacement (<= 20 mm or >20 mm), hip dislocation, delay in surgery (<= 2 weeks or >2 weeks), associated injury and length of follow-up (<= 5 years or >5 years) on the functional outcome was evaluated. Results: There were 99 (83.9%) males and 19 (16.1%) females with mean age of 38.75 years (16 to 65 years). The mean duration of follow-up was 3.95 years (range 2 to 14 years). The mean Modified Postel Merle d'Aubigne score was 15.7 +/- 2.2 (range, 8 to 18). The clinical outcome was excellent in 27 (22.9%), good in 52 (44.2%), fair in 20 (16.9%), and poor in 19 (16.1%, 10 patients who underwent THR for secondary arthritis were considered as poor outcome) patients. The Modified Postel Merle d'Aubigne score was significantly affected by quality of reduction (P = 0.0001), presence of associated injuries (P = 0.0001), initial fracture displacement of > 20 mm (P = 0.018), joint dislocation (P = 0.015) and delay in surgery (P = 0.001). However, age, gender, fracture type and length of follow-up did not have any effects on the clinical outcome. Conclusion: Poor reduction, associated injuries, fracture displacement of > 20 mm, joint dislocation and late surgery definitely carry poor prognosis in predicting the outcome of surgically treated acetabular fractures. (C) 2013 Elsevier Masson SAS. All rights reserved.