Clinical and Radiological Evaluation of Surgically Treated Acetabulum Fractures

Abstract

Aim: Acetabular fractures were evaluated by Judet and Letournel in two main groups as elementary and associated fractures. There are publications in the literature that the results are worse as the complexity of the fracture increases. The aim of this study was to evaluate whether clinical outcomes are worse in associated fractured patients. Material and Methods: The study included 48 acetabular fractures admitted to the emergency room and treated surgically between December 2011 and October 2020. Patient’s trauma, additional injuries, surgical method, early or late complications, and range of motion at the last follow-up were documented. Clinical and radiological results of the patients were evaluated by modified Merle d'Aubigné, functional capacities by Harris hip scoring systems. Results: There were 25 elementary fractures and 23 associated fractures in patients. When the complication rates were examined, the rate of those without complications was 52.0% (n=13) among elementary fractures, while the rate was 34.8% (n=8) in associated fractures. When the fracture types were evaluated according to the Harris hip score, elementary fractures have better score than associated fractures, but no statistically significant difference was observed between them (p=0.056). When evaluated according to Merle d'Aubigne score, it was observed that elementary fractures had significantly better scores (p=0.004). Conclusion: As the complexity of the fracture increases, it can be predicted that the clinical outcomes of the patient will be worse. It is also concluded that the elementary fracture type had better clinical outcomes than the associated fracture type in our own surgically treated acetabular fractures.

Keywords

• Acetabular fractures
• acetabular fracture types
• elemantary type fractures
• surgical treatment

Cerrahi Olarak Tedavi Edilen Asetabulum Kırıklarının Klinik ve Radyolojik Değerlendirmesi

Abstract

Amaç: Asetabulum kırıkları Judet ve Letournel tarafından elementer ve kompleks kırıklar olmak üzere iki ana grupta değerlendirilmiştir. Literatürde kırığın kompleksitesi arttıkça sonuçların daha da kötüleştiğine dair yayınlar bulunmaktadır. Bu çalışmanın amacı, kompleks kırıklı hastalarda klinik sonuçların daha kötü olup olmadığını değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, Aralık 2011 ve Ekim 2020 tarihleri arasında acil servise başvuran ve cerrahi olarak tedavi edilen kırk sekiz asetabulum kırığı dahil edildi. Hastaların travmaları, ek yaralanmalar, cerrahi yöntem, erken ve geç komplikasyonları ve son takipteki hareket açıklıkları kaydedildi. Hastaların klinik ve radyolojik durumları modifiye Merle d'Aubigné skoru ile ve fonksiyonel kapasiteleri ise Harris kalça skoru ile değerlendirildi. Bulgular: Yirmi beş hastada elementer kırık ve 23 hastada kompleks kırık mevcuttu. Komplikasyon oranları incelendiğinde elementer kırıklar içerisinde komplikasyon olmayanların oranı %52,0 (n=13) iken, kompleks kırıklarda oran %34,8 (n=8) idi. Kırık tipleri Harris kalça skoruna göre değerlendirildiğinde, elementer kırıklar kompleks kırıklardan daha iyi skora sahip olmakla birlikte aralarında istatistiksel olarak anlamlı bir farklılık gözlenmemiştir (p=0,056). Merle d'Aubigné, skoruna göre değerlendirildiğinde elementer kırıkların anlamlı derecede daha iyi skorlara sahip olduğu görüldü (p=0,004). Sonuç: Kırığın kompleksitesi arttıkça hastanın klinik sonuçlarının daha kötü olacağı tahmin edilebilir. Cerrahi olarak tedavi edilmiş asetabulum kırıklı kendi olgularımızda da, elementer kırık tipinin kompleks kırık tipine göre daha iyi klinik sonuçlara sahip olduğu sonucuna ulaşıldı.

Keywords

• asetabulum kırıkları
• asetabulum kırık tipleri
• temel kırık tipleri
• cerrahi tedavi

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