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Fracture characteristics and outcomes of acetabular fracture management with minimally invasive approach and percutaneous fixation

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The aim was to assess acetabular fracture outcomes of percutaneous fixation (PF) with or without minimally invasive surgery (MIS).

Methods

Between July 2011 and October 2016, acetabular fractures fixed with PF with or without MIS were included. Data collected are demographics, mechanism of injury, associated injuries, time to surgery, American Society of Anesthesiologists grade, fracture characteristics, surgical techniques, fracture reduction, secondary osteoarthritis (OA), revision surgery, patient survival and complications.

Results

Of 26 patients with a mean age of 56 years (19–86) (22 males and 4 females), 11 were < 50 years age (U50) and 15 were > 50 years (A50). Most common pattern was anterior column with posterior hemi-transverse. Three out of 11 U50 were minimally displaced and had PF only; the rest had MIS and PF. All had good fracture reduction, but 2 had secondary OA at follow-up but no further surgery. Eight out of 26 had secondary OA but only 3 needed surgery. Three (A50 with PF) with fair/poor reduction (deemed unfit for open reduction) had secondary OA but no further intervention. Three more (A50 with MIS + PF) had secondary OA treated with primary total hip replacement (THR). Complications were as follows: one foot drop recovered after immediate repositioning of screw, one cardiac event and one pulmonary embolism.

Conclusion

Fracture mal-reduction predicts secondary OA, but good fracture reduction does not prevent secondary OA. MIS and PF in elderly are useful even with suboptimal reduction as it sets the bed for a non-complex THR. Despite MIS surgery, medical complications are potentially significant.

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Funding

No funds, grants or other supports were received. The authors declare they have no financial interests.

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Authors and Affiliations

  1. Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK

    Ekansh Debuka, Gunasekaran Kumar, Neel Dalal & Sanjay Kalra

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  1. Ekansh Debuka
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  2. Gunasekaran Kumar
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  3. Neel Dalal
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  4. Sanjay Kalra
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All authors made substantial contributions to the work of the paper, confirm that the data provided are accurate and approve the final version being submitted.

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Correspondence to Ekansh Debuka.

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Debuka, E., Kumar, G., Dalal, N. et al. Fracture characteristics and outcomes of acetabular fracture management with minimally invasive approach and percutaneous fixation. Eur J Orthop Surg Traumatol 31, 1363–1368 (2021). https://doi.org/10.1007/s00590-021-02886-5

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  • DOI: https://doi.org/10.1007/s00590-021-02886-5

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