scholarly journals Assessment of functional outcome of operative management of displaced acetabular fractures and complications

2021 ◽  
Vol 7 (6) ◽  
pp. 1145
Author(s):  
Jawed A. Bhat ◽  
Tabasum Akbar ◽  
Abdul Hanan Javaid ◽  
Faizan Javaid ◽  
Faesal Mir ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Nerve Injury ◽  
Avascular Necrosis ◽  
Operative Management ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Operative Complications ◽  
Morbid Conditions

<p><strong>Background:</strong> Aim of the study was to assess the functional outcome of operative management of displaced acetabular fractures and complications.</p><p><strong>Methods:</strong> The study included sixty patients presenting within 2 weeks with displaced fractures of more than 2 mm. Elderly patients with osteoporotic bones and co-morbid conditions were excluded.</p><p><strong>Results: </strong>A total of sixty patients were operated on. Union was achieved in anatomical position in 51 patients (85%) and in malposition in 9 (15%) patients. Excellent results were obtained in 15 (25%) patients, good results in 32 (53%), fair results in 7 (11.6%) and poor results in 6 (10%) patients. Post operative complications included infection in 2 (3%), sciatic nerve injury in 2 (3%) and avascular necrosis (AVN) in 3 (5%) patients.</p><p><strong>Conclusions:</strong> In the present study, majority of the patients were operated within two weeks. The Harris hip score averaged 58.</p>

scholarly journals Evaluation of CE angle of Wiberg for the functional outcome in various hip pathologies: an observational study

2018 ◽  
Vol 5 (1) ◽  
pp. 182
Author(s):  
Juzer Bagwala ◽  
Susheel Soni
Keyword(s):  
Femoral Head ◽  
Observational Study ◽  
Functional Outcome ◽  
Avascular Necrosis ◽  
Femoroacetabular Impingement ◽  
Operative Management ◽  
Developmental Dysplasia ◽  
Developmental Dysplasia Of Hip ◽  
Necrosis Of Femoral Head ◽  
Non Operative Management

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate CE Angle of Wiberg for the functional outcome in various hip pathologies.</p><p class="abstract"><strong>Methods:</strong> This is a non-randomised prospective, observational study carried out for the period of 15 months. In this study 35 hips of 28 patients with hip pathologies with age more than 5 years of both genders, hip pathologies like CAM and/or Pincer type of femoroacetabular impingement, Acetabular retroversion, Perthes like deformity, osteoarthritis hip, avascular necrosis of femoral head, developmental dysplasia of hip were studed.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this prospective study out of 28 patients 9 (32.14%) were FAI, 8 (28.57%) were OA hip, 8 (28.57%) were avascular necrosis of femoral head and 3 case (10.71%) is of Perthes' disease. In FAI cases 4(44.44%) patients were of Pincer type, 5 (55.55%) were of combined type with no any case of isolated CAM form. All were unilateral involvement with average CE angle of 32.67<sup>0</sup>±11.67<sup>0</sup>. In Pincer type mean CE angle was 36.25<sup>0 </sup>±7.5<sup>0 </sup>while in Combined form the mean CE angle was 29.8<sup>0</sup>±14.4<sup>0</sup>. Out of 4 patients of Pincer FAI, 3 patients of Pincer type had CE angle between 25<sup>0</sup>-40<sup>0 </sup>which comes under normal range of CE angle, so all were planned for non operative management.</p><strong>Conclusions:</strong> We have found that all the hip pathologies reported to us had spectrum of variations in CE angle depending on the severity of disease. Variation was maximum seen in osteoarthritis and femoroacetabular impingement, in the cases of FAI maximum was of Pincer type.

scholarly journals Functional Outcome of Traumatic Acetabulum Fractures : A 6 Months Comprehensive Follow Up Following Open Reduction Internal Fixation Surgery at Saiful Anwar General Hospital Malang

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
DP Putra ◽  
AS Pradana ◽  
KY Phatama ◽  
E Mustamsir ◽  
M Hidayat
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
General Hospital ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Acetabulum Fractures ◽  
Harris Score ◽  
The Mean

Acetabular fractures commonly occurred in young adult patient who suffered from high impact trauma which often associated with life threatening injuries. Displaced acetabular fractures lead to abnormal distribution on joint cartilage pressures. It produces early cartilage disruption and development of premature osteoarthritis at the hip. Anatomical reduction and fixation operation in acetabulum fractures still a major challenges due to its complications such as poor functional outcome after surgery. Despite its difficulty to predict the outcomes of acetabular fractures surgeries, functional outcomes scoring such as Oxford Hip Score (OHS) and Harris score may help surgeon to measure long term outcome following acetabular fractures. A total of 13 patients were treated over period of January 2018 until March 2019 in Saiful Anwar General Hospital Malang. The mean age of patients in this serial case is 37 years old and were operated within 2 weeks of injury. All the patients undergone an ORIF (Open Reduction Internal Fixation) operation and observed for the OHS and also Harris score 6 months following surgeries to measure functional outcome of the patients. The mean score of OHS in this serial case is 41 (satisfactory joint function) and the mean score of harris hip score is 91 (excellent). Some patients experience pain during activities, tingling sensation after standing in some periods of time, and heaviness when taking stairs 6 months after operation. This results conclude that the preoperative, operative and post operative management of patient with acetabular fracture in Saiful Anwar Hospital has satisfactory results.

scholarly journals Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

2022 ◽  
pp. 30
Author(s):  
Keyword(s):  
Sciatic Nerve ◽  
Surgical Site Infections ◽  
Posterior Wall ◽  
Late Complications ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
Posterior Fixation ◽  
Operative Complications ◽  
Poor Outcomes ◽  
Post Operative Complications

The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve retractors. Other early and late complications included surgical site infections (12.3%) and heterotopic ossification (8.8 %), respectively. The overall outcome following surgery by the K-L approach is satisfactory. However, there is need to ameliorate the technique, especially at the level of instrumentation, to limit post-operative complications.

scholarly journals Outcome of external fixator in the treatment of intertrochanteric fracture in elderly patients with co-morbidities

2019 ◽  
Vol 7 (1) ◽  
pp. 3-7
Author(s):  
Deepak Kumar Dutta ◽  
R, Sinha
Keyword(s):  
Elderly Patients ◽  
Functional Outcome ◽  
External Fixator ◽  
Intertrochanteric Fracture ◽  
Harris Hip Score ◽  
External Fixators ◽  
Intertrochanteric Fractures ◽  
Early Ambulation ◽  
Medical Comorbidities ◽  
Mean Time

Background and Objectives: Incidence of intertrochanteric fracture is rising because of increasing number of elderly. They tend to have many comorbidities of different systems; therefore, major surgeries are not possible at times. In these patients, external fixator can be an option as it promotes early ambulation, thereby preventing recumbency-associated complications. Material and Methods: Elderly patients of interetrochanteric fracture and with medical comorbidities were managed with external fixator. Functional outcome was measured by Harris Hip Score (HHS) on first post-operative day and in follow ups on 4, 12, and 24 weeks. Results: Thrity patients (19 males, 11 females), of mean age 77.63 years (SD=9.06) were studied. HHS scores steadily increased from 37.6±5.28 on the first post-operative dayto 49.43±6.9 on 4 weeks, 59.83±7.17 on 12 weeks, and 72.47±4.17 on 24 weeks. The changes were all very highly significant (all p=0.000). Mean time taken to union was 14.67±2.28 weeks. None of the patients had recumbency-related complications. Conclusion: External fixators for intertrochanteric fractures in medically comorbid elderly patientsis effective in promoting ambulation and preventing recumbency-related complications.

scholarly journals Delayed total hip arthroplasty in patients developing osteoarthritis following acetabular fractures

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Jatinder S. Luthra ◽  
Salim AL Habsi
Keyword(s):  
Sciatic Nerve ◽  
Total Hip Arthroplasty ◽  
Nerve Injury ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Sciatic Nerve Injury ◽  
Acetabular Fractures ◽  
Short Term ◽  
Independent Observer ◽  
Total Hip

Objectives: The aim of this study is to review the short-term results of total hip arthroplasty (THA) for the management of delayed arthritis after acetabular fractures. Methods: This is a retrospective study of operated cases of THA post-acetabular fracture arthritis. Data were collected from computerized hospital records from January 2010 to December 2019. We analyzed post-operative outcomes, which included revision surgery due to any reason, post-operative infection, hip dislocation, sciatic nerve injury, and deep venous thrombosis. In addition, radiographs were evaluated for restoration of the center of rotation (COR), horizontal offset (HO), and vertical offset (VO) by an independent observer. Results: A total of 36 cases (30 males and six females) were included in the study. The average age was 55 years. Road traffic accidents were the most common cause of fractures followed by falls from height. The mean time between the fracture and the development of symptoms of arthritis was 48 months. One THA was complicated by post-operative dislocation. Infection was reported in three cases and sciatic nerve injury occurred in one patient. Heterotopic ossification was seen in four cases and thromboembolism developed in one patient. The COR, HO, and VO showed a normal pattern. Conclusion: THA after acetabular fractures is a complex surgical procedure with relatively high short-term complications. Restoring the hip biomechanics can help in achieving results that are comparable to primary total hip replacement.

scholarly journals Functional outcome following conservative management of acetabular fractures

2020 ◽  
Vol 6 (5) ◽  
pp. 1027
Author(s):  
Rajagopal H. P. ◽  
Madan Mohan M. ◽  
Binu T. Kurian ◽  
Ramesh L. J. ◽  
Anoop Pilar ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Conservative Management ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Functional Evaluation ◽  
College Hospital ◽  
Outcome Scores ◽  
Hospital Patients

<p class="abstract"><strong>Background:</strong> Acetabular fractures are complex injuries caused due to high velocity injury and constitutes about 18 % of Pelvic fractures. To obtain articular congruency and anatomical reduction is the gold standard in treating these fractures. In this study we have studied about the functional outcome in acetabular fractures managed conservatively with the long-term follow.</p><p class="abstract"><strong>Methods:</strong> A retrospective study with prospective analysis done between 2011-2020 involved 39 patients with acetabular fractures who were treated conservatively at St John’s Medical college Hospital. Patients were followed up at 6 months, 1 year, 2 years and at the end of 5 years for functional evaluation and assessment with the clinical outcome scores with Merle d’Aubigne and Postel score &amp; Harris Hip Score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Study included 39 patients with the average age of 41.3 years with 31 male and 8 female patients. Functional outcome score showed good to excellent results in 80%, fair to satisfactory results in 18%, 0.5 to 2% had poor result in the patient analyzed with both Merle d’Aubigne and Postel score and Harris Hip Score. 80 % of the patients were able to sit cross legged, 90% had returned to regular work and 10% of the patients changed their occupation to desk jobs.</p><p class="abstract"><strong>Conclusions:</strong> Conservative management of acetabular fractures gives a good long-term result following congruent reduction of the fracture, good early rehabilitation and gradual weight bearing. Return to activity of daily living was good even in congruently reduced acetabular dome fractures with good to excellent functional outcome scores.</p>

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