Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.
Matta JM. The Journal of bone and joint surgery. American volume 1996 · PMID 8934477
- Question
- Does the accuracy of surgical reduction of displaced acetabular fractures predict long-term clinical outcome?
- Design
- Large single-surgeon cohort of operatively treated displaced acetabular fractures with medium-term follow-up.
- Patients
- Patients with displaced acetabular fractures treated by open reduction and internal fixation within three weeks of injury.
- Intervention
- Open reduction and internal fixation, with reduction graded on residual displacement as anatomical, imperfect or poor
- Comparison
- Outcomes compared by quality of reduction
- Primary outcome
- Clinical hip score (modified Merle d'Aubigné) and radiological arthritis
- Key result
- Most hips achieved an anatomical reduction, which was harder to obtain in complex patterns, older patients and with longer delay to surgery. Clinical outcome tracked the radiographic result: anatomical reduction and a congruent roof predicted good results, whereas femoral head injury, older age and operative complications predicted poorer ones.
- Limitations
- Single expert surgeon series, so results may not generalise; non-randomised.
- Impact on practice
- Established anatomical reduction as the goal of acetabular ORIF, with early surgery by an experienced surgeon, and the Matta reduction grading used in audit, research and exams.