Surgical treatment of complex acetabular fractures

Objective To explore the key factor of complex acetabular fracture.Methods All of 41 patients with the complex acetabular fractures were treated with reconstruction plate internal fixation.The clinical efficacy according to PostelD'Aubigne score was evaluated in terms of ages,lesion mechanism,fracture type,combined injury,surgery occasion,the quality of reduction and whether there're traumatic arthritis.Results According to Matta reposition standard: 19 cases were anatomical reduction,18 cases were satisfactory reduction,4 cases were no satisfactory reduction.All the 41 cases were followed up for 38 to 92 months,with an average of(54.0±2.8) months.According to Postel-D'Aubigne score,the result was excellent in 14 cases,good in 16,fair in 6,and bad in 5,with the excellent and good rate of 73.2%.In the anatomic reduction group the excellent and good rate was 89.5%(17/19),and 59.1%(13/22) in the non-anatomic reduction group.The difference was statistically significant(χ2=4.79,P =0.03).Conclusion It is very important to treat acetabular fractures with surgery as soon as the vital signs are stable,use the reduction techniques and fixation methods correctly,make the best of the femoral head or neck fracture,complete the fracture fixation with the reconstruction plate and lag screw in the same approach and prevent traumatic arthritis.