A retrospective analysis of different treatments of posterior acetabular wall fracture

Abstract

Introduction/Objective. The objective of the paper is an analysis of clinical outcomes of non-surgical conservative and operative management of patients with posterior acetabular wall fractures. Methods. We investigated 88 fractures of the acetabular joint, 31 of which were treated surgically and 57 non-surgically. Only screws or reconstruction plates and screws were used for surgical treatment and traction in patients who underwent nonsurgical treatment. The study period lasted at least three years. The measures used to assess the outcome of operative, surgical and non-operative, conservative approach were Merle d’Aubigne modified score, Harris hip score, and Matta’s radiometric criteria. Results. Matta’s evaluation criteria showed an excellent score of 40.4% in conservatively treated patients; 19.4% in patients who underwent surgery; a good score of 49.1% in conservatively treated patients; and 48.4% in patients who underwent surgery. Comparation between two patient groups differently treated, by Merle d’Aubigne tool, showed excellent results for 56.1% conservatively treated patients and 25.8% in those patients who underwent surgery, and good results in 29.8% conservatively treated patients and 38.7% in patients who underwent surgery. Harris hip score (excellent results were showed in 54.4% for non-operative-treated patients) also showed statistical significance, p < 0.005. Conclusion. Proper diagnostics and a proper definitive diagnosis can help avoid surgical treatment if the fracture cannot be treated surgically, making the postoperative period more comfortable for the patient.

Keywords

• acetabulum
• fracture
• non-operative treatment
• operative treatment