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Predictors of clinical and radiological outcome in patients with fractures of the acetabulum and concomitant posterior dislocation of the hip

¹ Hamilton Health Sciences-General Hospital, 237 Barton Street East, 7 North Wing, Suite 727, Hamilton, Ontario, Canada L8L 2X2.
² St. John’s Health Center, Orthopedic Centre, 1328 Twenty Second Street, Santa Monica, California 90404, USA.
³ UC-Davis Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Sacramento, California 95817, USA.
⁴ MeritCare Southpointe, 2400 32nd Avenue South, Fargo, North Dakota 58103, USA.

Correspondence should be sent to Dr M. Bhandari; e-mail: bhandam{at}mcmaster.ca

We aimed to identify variables associated with clinical and radiological outcome following fractures of the acetabulum associated with posterior dislocation of the hip. Using a prospective database of 1076 such fractures, we identified 109 patients with this combined injury managed operatively within three weeks and followed up for two or more years. The patients had a mean age of 42 years (15 to 79), 78 (72%) were male, and 84 (77%) had been involved in motor vehicle accidents. Using multivariate analysis the quality of reduction of the fracture was identified as the only significant predictor of radiological grade, clinical function and the development of post-traumatic arthritis (p < 0.001). All patients lacking anatomical reduction developed arthritis whereas only 25.5% (24 patients) with an anatomical reduction did so (p = 0.05).

The quality of the reduction of the fracture is the most important variable in forecasting the outcome for patients with this injury. The interval to reduction of the dislocation of the hip may be less important than previously described.

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				P. V. Giannoudis, C. Tzioupis, and B. R. Moed Two-level reconstruction of comminuted posterior-wall fractures of the acetabulum J Bone Joint Surg Br, April 1, 2007; 89-B(4): 503 - 509. [Abstract] [Full Text] [PDF]