Abstract
Purpose: Open reduction and internal fixation (ORIF) is considered the treatment of choice in dislocated acetabular fractures. However ORIF has several drawbacks, such as intra operative blood loss, operative trauma and septic complications. To overcome these problems we applied percutaneous cannulated screw fixation in some cases.
Methods: 198 acetabular fractures were treated between 1996 and 2003 in our department. According to the AO classification there were: 74 type A, 99 type B and 25 type C cases. The causes of the trauma were fall from high at 29, traffic accident at 112 and simple drop with osteoporosis in 57 patients. There were 29 polytraumatized and 46 multitraumatized patients. The 89 non-displaced fractures were treated conservatively: 8–12 weeks non-weight bearing were applied. The other cases were treated surgically: the simple wall fractures with screws, the column fractures with plates. The ilioinguinal approach was used in 11 and the Kocher-Langenbeck in 92 patients. Recently we have started to apply a percutaneous technique with cannulated screws. We used them at the fractures of the roof of the acetabulum and at elderly patients who had moderately dislocated anterior column fracture. We applied this technique in 6 cases.
Results: In the cannulated screw group there was no intra- or postoperative complication, and the functional results have been excellent or good. In those cases, where the fracture involved the posterior wall or the posterior column, and percutaneous reduction could not have been achieved; we made open reduction, and ORIF.
Conclusions: Percutaneous cannulated screw technique can be useful in the treatment of the fractures of the anterior column and the dome of the acetabulum.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
