Operative Treatment Of Displaced Acetabular Fracture By Pelvic Reconstructive Plates And Screws

Objective To discuss the results and menthods of operative treatment of displaced acetabular fractures.Methods From March 1998 to April 2005, fracture reduction and fixation were carried out open reduction and internal fixation with pelvic reconstructive plates and screws in 36 cases of displaced acetabular fractures, in this series, 23 cases were treated through the kocher-langenbeck approach, 8 cases were performed through the ilionguinal approach, and the combined anterior and posterior approach were abopted for 4 cases, 1 case were treated through the extensive S-P incision. The functional rehabilitation program was carried out early after operation.Results The average follow-up period was 20.5 months(ranging from 8 to 48 months). The wounds healed primanly in all but 2 ilioinguinal approach cases, in which the wounds presented with exudation and healed after dressing-change 2 weeks. Complications included nerve injury in 2cases, hetrotopic ossification in 2 cases, of the 4 patients with sciatic nerve injury before surgery, 3 experiened improvement. No infection no pulmonary embolism, Nonunion were found. Anatomical and satisfactory reduction in 32 cases, unsatisfactory reduction in 3, poor in 1 when evaluated with Matta radiographic grade. The clinical evaluation was done with the modified Merle d' Aubigne and Postel clinical grading system and showed excellent and good result in 30 cases, fair in 4cases, poor in 2 cases.