"Acetabulum Fractures: Mechanism of Injury, Demographic Features and Associated Injuries"

Abstract

Objectives: The objective of this study was to know about the demographic characteristics of patients with acetabulum fractures, and to know about common associated injuries and various management methods in a teaching hospital of northern Pakistan. Setting: the study was carried out at the department of Orthopaedics and spine surgery Hayatabad Medical Complex, Peshawar. Study Design: Descriptive case series Methods: All patients admitted to the department with acetabulum fractures were included in the study from January 2015 to December 2020. The patients were assessed and resuscitated, the demographic features noted, mechanism and severity of injury were recorded, and radiological evaluation including CT scans were done and fractures classified according to Judet and Letournel classification system. The operative details were recorded including surgical approach and fracture fixation. Results: There were 69 patients in this study, 61 were male and 8 were female. Average age at the time of injury was 34 years and ranged from 22-72 years. Out of our data pool 65 patients got admitted via Accident and Emergency and only 4 patients presented to our outpatient departmente-3]. Average Injury Severity Score at the time of injury was calculated to be 12.8. Commonest mechanism of injury was reported to be high energy trauma 62(89.8%). Road traffic accident was the commonest mode of injury i.e. 47(68.11%) According to the Letournel classification, two fracture types were most common i.e. posterior wall fracture 20 (28.99%) and both column fracture 17(24.64%). Thirty nine patients had associated injuries out of which injured hip dislocation was prevalent i.e.11(28%). Open reduction and internal fixation was the preferred management for 49(71%) patients while 19(27.54%) patients were conservatively managed. Out of those that were surgically managed 40(81%) patients fracture was approached via Kocher-langenbeck approach. Conclusions: Acetabular fractures are common in young adults and the most common mechanism of injury is road traffic accidents. The common fractures are posterior wall and both column injuries and associated with hip dislocation. The preferred method of treatment is surgical fixation through Kocher langenback approach.