Clinical and radiological evaluation of surgically treated acetabulum fractures

Treatment of acetabulum fractures; The complex anatomy of the region, difficulties in reaching the fracture, being a relatively rare injury, difficult surgical technique and possible complications are among the issues that maintain their importance. Possible complications of acetabular fractures are neurological injury, infection, avascular necrosis (AVN), heterotropic ossification (HO), deep vein thrombosis (DVT), posttraumatic arthrosis, pulmonary embolism (PE), and mortality. The quality of reduction directly affects patient satisfaction, prevention of posttraumatic arthrosis development and preservation of normal joint functions. In our study, patients who were operated for acetabular fracture between January 2013 and January 2021 were retrospectively scanned. We evaluated the clinical and radiological outcomes of 65 patients who met the inclusion criteria. Merle D'Aubine Rating Scale and Harris Hip Scale were used for clinical evaluation. The Matta Reduction Quality scale and the Matta Radiological Outcome scale were used radiologically. As a result of the study, it was observed that musculoskeletal or other system injuries were accompanied in addition to acetabulum fracture in the majority of patients injured by major trauma. It was determined that CT examination was required in addition to direct X-rays in the diagnosis, and the most common fracture type in the patients examined was posterior wall fracture. It was observed that the quality of postoperative reduction and clinical results were not related to T-O time. It was determined that the risk of HO increased in the Kocher-Langenbeck (K-L) approach and combined surgical approaches. It was evaluated that the K-L approach did not have a direct effect on AVN. It was evaluated that the clinical results improved according to the reduction quality in parallel with the radiological results, but the clinical scores were better than the radiological results. On the other hand, it has been determined that anatomical reduction does not directly affect good clinical results and there are many parameters that are effective on the clinic.