Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;45(1):247-251.
doi: 10.1007/s00264-020-04885-3. Epub 2020 Nov 26.

Knee injuries concomitant to posterior acetabular fractures: an association to look for

Maroun Rizkallah  1   2   3 , Elias Melhem  4 , Hichem Abid  4   5 , Francois Boillot  4 , Pomme Jouffroy  4 , Guillaume Riouallon  4
Affiliations

Knee injuries concomitant to posterior acetabular fractures: an association to look for

Maroun Rizkallah et al. Int Orthop. 2021 Jan.

Abstract

Purpose: Acetabular fractures are frequently associated with other skeletal injuries, particularly knee injuries. This study aims to evaluate the relationship between posterior acetabular fractures and knee injury, analyzing its patterns and association with other injuries.

Methods: This is a retrospective monocentric study in a tertiary referral centre. We reviewed the data (age, sex, type of fracture, and concomitant injury) of patients hospitalized for a posterior acetabular fracture. We recorded concomitant knee injury diagnosed up to one year following acetabular fracture.

Results: Two-hundred-seventeen patients (177 males/40 females) were included. The mean age was 40.5 years. Eighty-five patients (39%) had a concomitant hip dislocation, nine (4.1%) had sciatic nerve palsy, 17 (7.8%) had upper extremity injury, and 18 (8.3%) had lower extremity injury (other than the knee). Eight (3.7%) patients had spine injury, 11 (5.1%) had severe thoracic injury, nine (4.1%) had an abdominal injury, and four (1.8%) had a head injury. There were 33 (15.21%, 95% CI 10.80-20.8%) patients (30 M/3 F) (group 1) with a concomitant knee injury and 184 patients without a concomitant knee injury(group 2). The mean age in group 1 was 34.3 compared to 45.4 in group 2(p = 0.021). The pattern analysis revealed five fractures, 14 ligamentous injuries (PCL injuries = 68%), and 14 soft tissue injuries. Sixteen (48.48%) injuries were identified during hospitalization and 17 (51.51%) during follow-up. There were an association between knee injury and upper extremity injury (OR = 3.49 95% CI 1.12-10.00,p = 0.022) and other lower extremity injury (OR = 3.18 95% CI 1.03-8.95,p = 0.032).

Discussion: Knee injury is the second most frequent lesion associated with posterior acetabular fractures. Being missed in half of cases, we recommend a systematic examination of ipsilateral knees under general anaesthesia, keeping a high index of suspicion and a low threshold for complementary knee imaging. Knee injury should be mainly looked for in patients younger than 60 years and in those with upper and/or lower extremities injuries.

Keywords: Acetabular fracture; High-energy trauma; Knee; PCL.

PubMed Disclaimer

References

    1. Moed BR, Kregor PJ, Reilly MC, Stover MD (2017) Acetabular fractures: a problem-oriented approach. Instr Course Lect 66:3–24 - PubMed
    1. Hoge S, Chauvin BJ (2019) Acetabular Fractures. In: StatPearls. StatPearls Publishing, Treasure Island
    1. Judet R, Judet J, Letournel E (1964) Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 46:1615–1646 - DOI
    1. Letournel E (1980) Acetabulum fractures: classification and management. Clin Orthop Relat Res (151):81–106
    1. Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78:1632–1645 - DOI

LinkOut - more resources