Evaluation of Operative Management of Displaced Acetabular Fractures by Single Non-Extensile Surgical Approach

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Introduction:Fractures of the acetabulum and pelvis constitute only 2% of all fractures.but they are associated with significant morbidity and mortality due to associated injuries.In certain situations, single non-extensile surgical approaches cannot provide adequate visualisation and reduction of the fracture.To enhance visualization and anatomical stable reduction of fractures in such circumstances, a range of specific reduction tools, indirect reduction procedures, and additional surgical techniques can be employed.Aims/ objective: To measure the radiological and functional outcome of operative management of displaced acetabular fractures by using a single non-extensile surgical approach.Materials and Method: 21 cases of radiologically proven cases of displaced acetabular fracture were includedFor classification of fractures, Judet and Letournel's classification was used.Functional outcome was assessed at 6 months with the clinical grading criteria devised by Modified Merle d'Aubigne and Postel, having three parameters: pain, ambulation and range of motion and will be graded as: Excellent-score 18, Good-score 15-17, Fair-score 13-14 and Poor-score < 13.Results: Out of 21 cases recruited in the study, 5 cases had excellent clinical outcome, 13 with good, 2 with fair and 1 with poor clinical outcomes.In our study 7 (33.33%)patients had fracture of the quadrilateral plate, among them 3 patients had transverse with posterior wall fracture.We used Ilioinguinal (anterior approach) 38.1% cases and Kocher-Langenbeck (posterior approach) in 13 (61.9%)cases.There was significant correlation between complications and clinical outcome (p<0.05).There was significant correlation between radiological grade and clinical outcome (p<0.05). Conclusion:The single non-extensile surgical approaches supplemented by indirect reduction and fixation by lag screws can minimize the indications for extensile or combined surgical approaches for the management of displaced acetabular fractures including complex fractures and can achieve satisfactory reduction as well as function by avoiding the complications of extensive surgeries.