MANAGEMENT OF SIMULTANEOUS FRACTURES OF THE ACETABULUM AND PELVIC RING: CLINICAL & FUNCTIONAL OUTCOMES.

Introduction The clinical and functional outcome following simultaneous fractures of the acetabulum and pelvic ring represent a challenge for the clinician and are currently obscure in the existing literature. Patients and Methods Between January 2003 and July 2009 all patients with combined pelvic and acetabular fractures were included in this prospectively study. Demographic details, mechanism of injury, ISS, surgical procedures, post-operative course, length of hospital stay, and radiological (Matta9s score) and functional outcomes (The Merle d9 Aubigne hip score) were recorded. The minimum follow up was 12 months (12–72). Results Out of 520 cases, 30 (21 males) patients met the inclusion criteria. The mean age was 32. 55% sustained lateral compression, 40% combined mechanism and 5% anterior/posterior type of injury pattern. 15 out of the 30 patients had sustained other injuries. The mean time from injury to definite reconstruction was 7 days (3–14). Ilioinguinal approach was used in 20 patients, Pfannestiel in 2 and Kocher-Langebeck in 4. A wheelchair was used initially in 22 cases. The median time to FWB was 3 months. One patient underwent a THR at 18 months. 19 patients scored the full 18 points of the Merle score. Matta radiological score was excellent in 16 patients, Good 11, Fair 2, Poor 1. Conclusion The management of these injuries poses many difficulties to the trauma surgeon. With the available expertise in place good outcomes can be obtained as seen in this series of patients.