Complications After Surgical Treatment of Acetabular Fractures: a 5-year Follow-up of 229 Patients

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2022 May 20

PMID 35593939

Authors

Natalie Lundin

Hans E Berg

Anders Enocson

Affiliations

Soon will be listed here.

Abstract

Purpose: Acetabular fractures are injuries often surgically treated, but the surgical intervention is associated with a high risk of subsequent complications. The primary aim of this study was to explore the rate of reoperations and to identify potential risk factors for reoperation. Secondary aims were other adverse events and mortality.

Methods: Patients ≥ 18 years with a surgically treated acetabular fracture at a single trauma center in Sweden between 2010 and 2019 were retrospectively included. Data were collected through review of medical records and radiographs. Logistic regression analysis was performed to investigate factors associated with reoperations and other adverse events.

Results: A total of 229 patients with a surgically treated acetabular fracture were included, mean age (± SD, range) 60 (19, 19-94) years. The majority of the patients were males (n = 180, 79%), and the median (IQR) follow-up time was 1779 (1906) days (4.9 years). 47 patients (21%) underwent a reoperation. THA as surgical method was associated with a lower reoperation rate compared to ORIF (OR 0.3, 95% CI 0.1-0.8, p < 0.01). 72 patients (31%) sustained an adverse event not requiring reoperation, and admittance to ICU was associated with an increased risk (OR 2.6, 95% CI 1.2-5.7, p = 0.02). 30-day mortality was 3.1% and 1-year mortality 5.7%.

Conclusion: The complication rate after acetabular fracture surgery was high, and surgical treatment with primary THA was associated with a reduced risk for reoperation.

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References

Rinne P, Laitinen M, Huttunen T, Kannus P, Mattila V . The incidence and trauma mechanisms of acetabular fractures: A nationwide study in Finland between 1997 and 2014. Injury. 2017; 48(10):2157-2161. DOI: 10.1016/j.injury.2017.08.003. View

Melhem E, Riouallon G, Habboubi K, Gabbas M, Jouffroy P . Epidemiology of pelvic and acetabular fractures in France. Orthop Traumatol Surg Res. 2020; 106(5):831-839. DOI: 10.1016/j.otsr.2019.11.019. View

Lundin N, Huttunen T, Berg H, Marcano A, Fellander-Tsai L, Enocson A . Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden. Injury. 2021; 52(6):1410-1417. DOI: 10.1016/j.injury.2021.03.013. View

Enocson A, Blomfeldt R . Acetabular fractures in the elderly treated with a primary Burch-Schneider reinforcement ring, autologous bone graft, and a total hip arthroplasty: a prospective study with a 4-year follow-up. J Orthop Trauma. 2013; 28(6):330-7. DOI: 10.1097/BOT.0000000000000016. View

Ding A, OToole R, Castillo R, Reahl B, Montalvo R, Nascone J . Risk Factors for Early Reoperation After Operative Treatment of Acetabular Fractures. J Orthop Trauma. 2018; 32(7):e251-e257. DOI: 10.1097/BOT.0000000000001163. View

Judet R, JUDET J, LETOURNEL E . [FRACTURES OF THE ACETABULUM]. Acta Orthop Belg. 1964; 30:285-93. View

PIPKIN G . Treatment of grade IV fracture-dislocation of the hip. J Bone Joint Surg Am. 1957; 39-A(5):1027-42 passim. View

Saterbak A, Marsh J, Nepola J, Brandser E, Turbett T . Clinical failure after posterior wall acetabular fractures: the influence of initial fracture patterns. J Orthop Trauma. 2000; 14(4):230-7. DOI: 10.1097/00005131-200005000-00002. View

Giannoudis P, Grotz M, Papakostidis C, Dinopoulos H . Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br. 2005; 87(1):2-9. View

10.

Meena U, Tripathy S, Sen R, Aggarwal S, Behera P . Predictors of postoperative outcome for acetabular fractures. Orthop Traumatol Surg Res. 2013; 99(8):929-35. DOI: 10.1016/j.otsr.2013.09.004. View

11.

Culemann U, Holstein J, Kohler D, Tzioupis C, Pizanis A, Tosounidis G . Different stabilisation techniques for typical acetabular fractures in the elderly--a biomechanical assessment. Injury. 2009; 41(4):405-10. DOI: 10.1016/j.injury.2009.12.001. View

12.

Mears D, Velyvis J . Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am. 2002; 84(1):1-9. DOI: 10.2106/00004623-200201000-00001. View

13.

Suzuki T, Morgan S, Smith W, Stahel P, Gillani S, Hak D . Postoperative surgical site infection following acetabular fracture fixation. Injury. 2009; 41(4):396-9. DOI: 10.1016/j.injury.2009.11.005. View

14.

Sermon A, Broos P, Vanderschot P . Total hip replacement for acetabular fractures. Results in 121 patients operated between 1983 and 2003. Injury. 2008; 39(8):914-21. DOI: 10.1016/j.injury.2007.12.004. View