Short-term results of percutaneous treatment of acetabular fractures: functional outcomes, radiographic assessment and complications

Abstract

Purpose: Our purpose was to assess functional outcomes, radiographic characteristics and complications in patients who underwent fixation of acetabular fracture using percutaneous means only.

Methods: This was a retrospective cohort study of adult patients with an acetabular fracture admitted to a level 1 trauma centre and treated with closed reduction and percutaneous fixation. Nineteen patients were identified, and mechanism of injury, radiologic classification of fracture, complications and functional outcomes were analysed. Outcome measurements included Patient Reported Outcomes Measurement Information System (PROMIS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, which are validated patient questionnaires assessing functional outcome. They are scored as a point range on a per-question basis, with a combined range possibility of 0-96 for WOMAC and 5-75 for PROMIS.

Results: Nineteen patients over a two year period were reviewed. Fracture displacement improved following surgery from a mean 7.3 mm (range 0-33 mm) to 2.6 mm (range 0-12 mm). Complications included one post-operative death from non-ST-segment elevation myocardial infarction, sciatic nerve injury, malpositioned screw and deep infection. There were no vascular injuries, pulmonary emboli or deep venous thromboses. Of the 19 patients eligible for the study, seven completed both PROMIS mobility and WOMAC osteoarthritis questionnaires at a mean follow-up of 572 days (1.57 years), with a range of 435-862 days. The average WOMAC score was 7.4 (range 0-30) and mean PROMIS score 66.4 (range 50-75).

Conclusions: Functional outcomes in this study are comparable with other published studies and support percutaneous management of acetabular fractures as an effective alternative to open reduction and internal fixation.

Keywords: Acetabular; Closed reduction; Fracture; Percutaneous.