Published in:
01-10-2016 | Original Paper
Part 2: outcome of acetabular fractures and associated prognostic factors—a ten-year retrospective study of one hundred and fifty six operated cases with open reduction and internal fixation
Published in: International Orthopaedics | Issue 10/2016
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Questions/purposes
The aim of this study was to identify prognostic factors associated with a poor quality of reduction and their relationships.
Methods
Data from medical charts for all patients admitted with acetabular fractures operated by open reduction and internal fixation (ORIF) from 2005 to 2014 were extracted. A total of 156 patients with a mean age of 40.3 years were included. All patients were reviewed at six months of follow-up. The prognostic factors analyzed were clinical and radiological factors. A new radiological parameter was also studied: the scanographic roof-arc angle. Specific statistical analysis was performed using a logistic regression model.
Results
Using a multivariate analysis logistic regression model: roof impaction (p = 0.001; OR = 6.59; CI 95% [2.01–20.97]), transverse + posterior wall (p = 0.03, OR = 2.52; CI 95% [1.46–13.65]) and surgeons in training (p = 0.02; OR = 1.24; CI 95% [1.07–3.32]) were three independent prognostic factors. Lower values of medial and posterior scanographic roof-arc angle were associated with unsatisfactory reduction. A significant association between unsatisfactory reduction and posterior roof arc angle < 61° was found.
Conclusions
Three independent prognostic factors associated with a risk of unsatisfactory reduction in ORIF for acetabular fractures were identified: roof impaction, transverse + posterior wall fracture and surgeons in training. Scanographic roof-arc angle seems to be a new prognostic factor.
Level of Evidence Level 4 retrospective study