Evaluation of Functional Outcome Following Fixation of Both Columns in Acetabular Fractures

Abstract Background: Acetabular fractures involving both columns are traditionally treated by fixation of a single column while indirectly reducing or overlooking the other column. This project was used to evaluate the functional outcome in acetabular fractures treated with fixation of both anterior and posterior columns. Materials and Methods: A prospective interventional study was performed at a Level 1 trauma and referral center from 2017 to 2019 on 30 patients suffering from complex both column acetabular fractures treated with open reduction and internal fixation. The reduction was evaluated using anteroposterior and Judet view radiographs. Functional outcome was evaluated using Visual Analog Score (VAS), Modified Merle d’Aubigné Score, and Harris Hip Score. Results: The average age was 40.8 years (18–59 years). There were 70% male and 30% female patients. The average duration of surgery was 6.1 h, blood loss 802.17 mL, and transfusion 1.53 units. The average duration of hospital stay was 19.07 days. Posterior dislocation was seen in 6 patients, whereas 3 had central and 2 anterior dislocations. A combination of plating with screw fixation was used in 43.3% of patients, whereas the rest were treated with plating only. No complications were seen in 80% of the patients. The average VAS score was 0.17 at 3 months. The functional outcome was excellent, as evidenced by the average Modified Merle d’Aubigné score of 17.0 of possible 18 and Harris Hip Score of 98.13 of possible 100 at 6 months postoperatively. Conclusion: Fixation of both anterior and posterior column, for complex acetabular fractures involving both columns, shows superior articular reduction and excellent functional outcome.