Acetabular fractures: classification and surgical treatment of 65 cases

ABSTRACT

The material of this study was composed of 65 cases of fracture of the acetabulum treated surgically, in two hospitals in Cairo over the period between January 1982 and December 1988. There were 60 males [92.3%] and 5 females [7.7%], aged 35 to 52 years. Most of them sustained the injury in a motor-car accident [58 or 89.3%]. There were 79 associated head, chest, abdominal or skeletal injuries, or 1.1 associated injury per case. The follow up period was 14- 84, average 48 months. They could be classified into two categories and 14 types. Category A included isolated, and Category B, combined fractures. The overall result was satisfactory in 40 cases [61.5%]. There were more satisfactory cases among those operated in the first few days, and the number of satisfactory cases diminished gradually the more the treatment was delayed. There were more satisfactory cases in Category A than in Category B fractures. The latter category included more severe fractures. One patient died early postoperatively from pulmonary embolism. Other cases of early general complications of fat embolism and white lung syndrome [1 case], deep vein thrombosis [6], and pulmonary embolism [2] resolved themselves safely. Early postoperative sciatic nerve palsy [2] recovered spontaneously. Early deep wound infection [2] ended in destruction of the hip joint and its pathological dislocation. Late complications compromised the functional results: avascular necrosis of the head of the femur [2], capsulitis ossificans [20], myositis ossificans [3], pathological dislocation from late deep infection [1], traumatic osteoarthritis of the hip [12]