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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 6,
776-782.
doi: 10.1302/0301-620X.88B6.17342 Copyright © 2006 by British Editorial Society of Bone and Joint Surgery Determinants of functional outcome after simple and complex acetabular fractures involving the posterior wallH. J. Kreder, MD, MPH, FRCS(C), Associate Professor1; N. Rozen, MD, Professor2; C. M. Borkhoff, MSc, Research Associate3; Y. G. Laflamme, MD, FRCS(C), Assistant Professor4; M. D. McKee, MD, FRCS(C), Associate Professor3; E. H. Schemitsch, MD, FRCS(C), Professor3; and D. J. G. Stephen, MD, FRCS(C), Assistant Professor1
1 Division of Orthopaedics, Sunnybrook Health Science Centre, Suite MG365, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5. Correspondence should be sent to Dr H. J. Kreder c/o Bev Bulmer; e-mail: bev.bulmer{at}sunnybrook.ca
We have evaluated the functional, clinical and radiological outcome of patients with simple and complex acetabular fractures involving the posterior wall, and identified factors associated with an adverse outcome. We reviewed 128 patients treated operatively for a fracture involving the posterior wall of the acetabulum between 1982 and 1999. The Musculoskeletal Functional Assessment and Short-Form 36 scores, the presence of radiological arthritis and complications were assessed as a function of injury, treatment and clinical variables. The patients had profound functional deficits compared with the normal population. Anatomical reduction alone was not sufficient to restore function. The fracture pattern, marginal impaction and residual displacement of > 2 mm were associated with the development of arthritis, which related to poor function and the need for hip replacement. It may be appropriate to consider immediate total hip replacement for patients aged > 50 years with marginal impaction and comminution of the wall, since 7 of 13 (54%) of these required early hip replacement. This article has been cited by other articles:
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