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Journal Article
Research Support, Non-U.S. Gov't
Immediate full weightbearing after percutaneous fixation of anterior column acetabulum fractures.
Journal of Orthopaedic Trauma 2012 Februrary
OBJECTIVE: To present clinical, radiographic, and functional outcomes of patients allowed immediate full weightbearing after closed reduction and percutaneous fixation of anterior column component acetabulum fractures.
DESIGN: Retrospective review.
SETTING: Academic Level I trauma center.
PATIENTS: Between September 2001 and December 2008, 28 patients with anterior column or anterior column posterior hemitransverse acetabulum fractures that were determined to be amenable to percutaneous fixation (at the discretion of the senior author [M.T.A.]) were selected.
INTERVENTION: All patients underwent closed reduction and anterior to posterior supra-acetabular percutaneous screw fixation followed by immediate postoperative full weightbearing.
MAIN OUTCOME MEASUREMENTS: Primary outcome measures included clinical, radiographic, and functional outcomes assessed with the modified Merle d'Aubigne Score and the Short Musculoskeletal Function Assessment questionnaire.
RESULTS: Six patients were lost to follow-up (less than 1 year), and the remaining 22 (79%) had a mean follow-up of 39 months (range, 12-74 months). There were no intraoperative complications. Radiographic grades were excellent in 19 patients, good in two patients, and fair in one patient. The mean modified Merle d'Aubigné Score was 17.4 (range, 11-18). The mean Short Musculoskeletal Function Assessment function and bothersome index were 20.2 (range, 0-72.8) and 20.1 (range, 0-72.9), respectively.
CONCLUSION: Clinical, radiographic, and functional outcomes of patients in this study are comparable to other reported studies. Despite an immediate full weightbearing protocol, complications, particularly poor final radiographic grade, do not appear common. The advantage of this protocol lies in the ability to immediately ambulate postoperatively with early return to work and recreation. We believe this technique is safe and offers a reasonable alternative for anterior column acetabulum fractures.
DESIGN: Retrospective review.
SETTING: Academic Level I trauma center.
PATIENTS: Between September 2001 and December 2008, 28 patients with anterior column or anterior column posterior hemitransverse acetabulum fractures that were determined to be amenable to percutaneous fixation (at the discretion of the senior author [M.T.A.]) were selected.
INTERVENTION: All patients underwent closed reduction and anterior to posterior supra-acetabular percutaneous screw fixation followed by immediate postoperative full weightbearing.
MAIN OUTCOME MEASUREMENTS: Primary outcome measures included clinical, radiographic, and functional outcomes assessed with the modified Merle d'Aubigne Score and the Short Musculoskeletal Function Assessment questionnaire.
RESULTS: Six patients were lost to follow-up (less than 1 year), and the remaining 22 (79%) had a mean follow-up of 39 months (range, 12-74 months). There were no intraoperative complications. Radiographic grades were excellent in 19 patients, good in two patients, and fair in one patient. The mean modified Merle d'Aubigné Score was 17.4 (range, 11-18). The mean Short Musculoskeletal Function Assessment function and bothersome index were 20.2 (range, 0-72.8) and 20.1 (range, 0-72.9), respectively.
CONCLUSION: Clinical, radiographic, and functional outcomes of patients in this study are comparable to other reported studies. Despite an immediate full weightbearing protocol, complications, particularly poor final radiographic grade, do not appear common. The advantage of this protocol lies in the ability to immediately ambulate postoperatively with early return to work and recreation. We believe this technique is safe and offers a reasonable alternative for anterior column acetabulum fractures.
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