Outcomes of Surgical Treatment of Acetabular Fractures with a Minimum of 1-Year Follow-up.

Backgroud: Acetabular fractures are rare and challenging to treat, and the surgeon's learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies. Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, single-center studies. According to the authors' literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year.

Methods: This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta's quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta's radiological outcome grading and the modified Postel Merle d'Aubigné score were confirmed as radiological and functional outcomes, respectively.

Results: The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (p = 0.009), quality of reduction (p < 0.001), and the Judet and Letournel classification (p = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (p < 0.001) and the Judet and Letournel classification (p = 0.030).

Conclusions: Our radiological and functional outcomes of acetabular fractures were comparable with those of other single-surgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.