Assessing the Outcomes of Displaced Acetabular Fracture Management Using A Single Non-Extensile Surgical Approach

Abstract

Background: Displaced acetabular fractures are complex injuries that significantly impact hip function and quality of life, often requiring surgical intervention to restore stability and mobility. Traditional surgical approaches can lead to complications and prolonged recovery, prompting the exploration of less invasive techniques.

Objective: This study aims to evaluate the efficacy and safety of a single non-extensile surgical approach for managing displaced acetabular fractures, assessing clinical and radiological outcomes.
Methods: An observational and prospective study was conducted involving 30 patients with displaced acetabular fractures treated at a tertiary care hospital in eastern India from February 2023 to February 2024. Patients underwent open reduction and internal fixation using standard non-extensile techniques, with outcomes evaluated through clinical grading and radiological assessments over a minimum follow-up of six months.

Result: Of the 30 patients, clinical outcomes were categorized as excellent (23.33%), good (60%), fair (10%), and poor (6.67%). Associated injuries significantly correlated with poorer outcomes (p=0.009). Radiological findings indicated that comminution and intra-articular fragments were significant predictors of poorer outcomes (p=0.0009 and p=0.023, respectively). The posterior surgical approach yielded better outcomes compared to the anterior approach, and shorter surgery duration was associated with improved results.
Conclusion: The study highlights that while demographic factors like age and sex do not significantly affect outcomes, associated injuries and specific radiological findings are critical determinants of clinical success. The posterior approach and reduced surgery duration are linked to better outcomes, emphasizing the potential benefits of a non-extensile surgical strategy in managing displaced acetabular fractures.