Outcome of surgical treatment of AO type: A acetabular fractures

Background: Acetabular fracture usually occurs due to high-velocity trauma and often affects the young and economically productive population. Previously, treatment of acetabular fracture was inadequate, and many patients were left with incapacitating pain and limitation of movement. Proper management should be given to save lives and minimize long-term complications and related disabilities. Objective: To evaluate the outcome of surgical treatment of AO type-A acetabular fractures. Methods: This prospective interventional study was carried out in Dhaka Medical College Hospital, Dhaka, from July 2019 to June 2021. A total of 20 cases were selected. Radiological and functional outcomes were evaluated six months after surgery according to Matta radiographic criteria and Merle d’Aubigne and Postel criteria, respectively. The effect of displacement of fracture fragment, reduction quality, hip dislocation, complication of operation, trauma to surgery time, associated injuries, age, and gender on the functional outcome were evaluated. Results: The age range was 21-60 years. The mean age was 36.5±11.5 years. Mean follow-up 7.30±2.15 months, range 6-12 months. According to Matta radiographic criteria, 6 months after surgery, 4 (20%) patients had excellent, 13 (65%) patients had good, and 3 (15%) patients had fair radiological outcomes. According to Merle d’Aubigne and Postel criteria, 6 months after surgery, 7(35%) patients had excellent, 10(50%) patients had good, and 3(15%) patients had fair functional outcomes. Overall functional outcome of the study population revealed that 17 patients (85%) belonged to satisfactory and three patients (15%) belonged to unsatisfactory outcome. Post-operative wound infection had occurred in 3(15%) patients, and foot drop had occurred in 1(5%) patient. 15 patients achieved anatomic (0, 1 mm) reduction. Three patients achieved imperfect (2, 3 mm) reduction, and two patients achieved poor (>3 mm) reduction. Conclusion: This study concludes that surgery of AO type-A acetabular fractures leads to satisfactory outcomes in the majority of cases.