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. 2023 Jan 4:36:132-136.
doi: 10.1016/j.jor.2023.01.001. eCollection 2023 Feb.

Outcomes of associated both-column acetabular fractures with and without a posterior wall fracture- A retrospective observational cohort study

G Bradley Reahl  1   2 , Michael F McTague  2   3 , Nishant Suneja  2   3 , Michael J Weaver  2   3 , Malcolm Smith  2   4 , Arvind G von Keudell  2   3   5
Affiliations

Outcomes of associated both-column acetabular fractures with and without a posterior wall fracture- A retrospective observational cohort study

G Bradley Reahl et al. J Orthop. .

Abstract

Aims & objectives: Our study sought to determine if posterior wall (PW) involvement in associated both-column acetabular fractures (ABCAFs) is associated with different clinical outcomes, primarily rate of conversion to total hip arthroplasty (THA), in comparison to ABCAFs with no PW involvement.

Materials & methods: This retrospective observational cohort study was performed at two academic Level 1 trauma centers. Two study groups were identified. The first study group consisted of 18 patients who sustained an ABCAF with PW involvement (+PW). The second study group consisted of 26 patients who sustained an ABCAF with no PW involvement (-PW). All patients achieved a minimum 12-months of follow-up and/or received a THA conversion procedure at a time remote to their index open reduction internal fixation (ORIF) procedure. The primary outcome of this study was subsequent conversion to THA on the injured hip. The secondary outcome was the presence of post-operative pain at ≥6 months and/or complications.

Results: No difference in rate of conversion to THA between + PW (n = 4, 22.2%) and -PW (n = 3, 11.5%) groups was demonstrated (p = 0.419). Similarly, no differences were seen between groups regarding complication rate (p = 0.814) and post-operative pain (p = 0.142).

Conclusion: Involvement of the PW does not appear to create worse clinical outcomes in comparison to no involvement in ABCAFs particularly as it relates to ipsilateral joint replacement.

Keywords: Acetabular fracture; Associate both-column acetabular fracture; Judet; Posterior wall fracture; Total hip arthroplasty.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Pre-operative CT (A), 3D-CT reconstruction (B), and intra-operative fluoroscopy following open reduction internal fixation (C) from 3 associated both-column acetabular fracture cases with posterior wall involvement.
Fig. 2
Fig. 2
Kaplan-Meier curve comparing survivorship to subsequent total hip arthroplasty between study groups. No difference between groups was demonstrated (p = 0.350).
See this image and copyright information in PMC

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