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Surgical treatment of unstable pelvic fractures with concomitant acetabular fractures

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Abstract

Purpose

To explore the diagnosis, treatment, and clinical prognosis of patients with both unstable pelvic fractures and concomitant acetabular fractures.

Material and methods

We retrospectively analyzed 21 cases of unstable pelvic fractures with concomitant acetabular fractures treated between January 2013 and December 2014. All 21 patients (18 males, 3 females), aged 43.5–55 years (range: 21–55 years), underwent surgery within four to 15 days (average = 6.5 days) after injury. We evaluated the pre-operative diagnoses, surgical approaches, types of fixation used, and prognoses.

Results

All 21 patients were followed-up for six to 18 months. The quality of post-operative pelvic fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 12, and fair in four. The clinical outcomes at the final follow-up (scored using the Majeed criteria) were excellent in ten cases, good in eight, and fair in three. The quality of post-operative acetabular fracture reduction (determined using the Matta scoring criteria) was excellent in five cases, good in 11, and poor in five. Hip joint function was evaluated at the final follow-up (using the D’Aubigné scoring system) and was excellent in eight cases, good in nine, and fair in four. The healing time was 12–18 weeks for pelvic fractures and 12–22 weeks for acetabular fractures. Post-operative wound infections in two patients were controlled after second operations featuring debridement and irrigation. We found no instance of heterotopic ossification, ischemic necrosis of the femoral head, or iatrogenic vascular or nerve injury.

Conclusions

Good therapeutic outcomes in patients with unstable pelvic fractures and concomitant acetabular fractures can be achieved via accurate diagnosis, careful pre-operative planning, a well-performed operation, effective reduction and surgical fixation, and appropriate exercise to allow functional rehabilitation.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (grant no. 81472146) and the Natural Science Foundation of WenZhou City (grant no. Y20160135). The funders played no role in the study design, data collection or analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, NO.109, XueYuan West Road, Luheng District, Wenzhou, Zhejiang, 325000, People’s Republic of China

    Leyi Cai, Yiting Lou, Xiaoshan Guo & Jianshun Wang

Authors
  1. Leyi Cai
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  2. Yiting Lou
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  3. Xiaoshan Guo
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  4. Jianshun Wang
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Correspondence to Jianshun Wang.

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Ethics statement

All procedures involving human participants were performed in accordance with the ethical standards of our institutional and national research committees, and with those of the 1964 Helsinki declaration and later amendments thereof, or comparable ethical standards. Formal Ethics Board consent was not required for this study.

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Cai, L., Lou, Y., Guo, X. et al. Surgical treatment of unstable pelvic fractures with concomitant acetabular fractures. International Orthopaedics (SICOT) 41, 1803–1811 (2017). https://doi.org/10.1007/s00264-017-3532-0

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  • DOI: https://doi.org/10.1007/s00264-017-3532-0

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