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Factors affecting the functional outcome of surgically managed displaced acetabular fractures.

PURPOSE OF STUDY
To evaluate the impact of various factors on functional outcome of surgically managed displaced acetabular fractures.


METHODS
In this prospective study 50 cases of surgically managed displaced acetabular fractures were followed up to a mean of 28.6±4 months (18-48 months). The effect of age, associated injuries, fracture pattern (elementary/associated type), time to surgery (<2 weeks/>2 weeks), accuracy of reduction (anatomical/imperfect/poor), gender and associated hip dislocation on the clinical outcome was evaluated using Harris hip score and modified Postel Merle d'Aubigné score.


RESULTS
The mean age was 36.6±11.9 years (range 19-67 years). There were 76% (n=38) males and 24% (n=12) females. 82% (n=41) patients sustained fracture due to motor vehicle accident. 60% of the cases had associated injuries. The mean Harris hip score at final follow-up was 80.96±8.9 and mean modified Merle d'Aubigné and Postel score was 15.1±2.4. The Harris Hip score and modified Postel Merle d'Aubigné score was significantly affected by presence of associated injuries (P=0.0025 and 0.0037 respectively), time to surgery (P=0.0087 and 0.0093 respectively), fracture pattern (P=0.015 and 0.023 respectively), associated hip dislocation (P=0.011 and 0.008 respectively), accuracy of reduction (P<0.05) and age (P<0.05), but gender (P=0.78 and 0.93 respectively) didn't have any significant effect on the clinical outcome.


CONCLUSION
The presence of associated injuries, concomitant hip dislocation, associated type of fracture patterns, elderly age (more than 60 years), sub optimal fracture reduction and delay in surgery beyond 2 weeks are factors that lead to statistically significant suboptimal functional scores.