Predictors of Clinical Outcomes In Surgically Treated Displaced Acetabular Fractures: A Single-Center Prospective Study
Abstract
Background: Acetabular fractures represent challenging injuries requiring complex surgical interventions to restore joint congruity and function. This prospective study aims to evaluate the functional and radiological outcomes of surgically treated displaced acetabular fractures and identify factors that predict clinical results.
Methods: A prospective analysis of 118 patients with displaced acetabular fractures treated surgically at a single tertiary care center was conducted over an 18-month period. Patients were followed for 12 months postoperatively. Fractures were classified according to the Letournel and Judet system. Functional outcomes were assessed using the Modified Harris Hip Score, while radiological outcomes were evaluated using Matta's reduction criteria. Statistical analysis was performed to identify factors associated with clinical outcomes.
Results: The mean age was 41.36 years, with males comprising 73.7% of patients. Road traffic accidents (53.4%) were the predominant injury mechanism. Associated both-column fractures (25.4%) were most common, followed by T-type fractures (24.6%). The Modified Stoppa approach was most frequently employed (54.2%). According to the Modified Harris Hip Score, 48.3% of patients achieved excellent results, 34.7% good, 11.9% fair, and 5.1% poor. Anatomical reduction (<1mm displacement) was achieved in 65.3% of cases. Marginal impaction (p=0.01), initial displacement magnitude (p=0.02), and quality of reduction (p=0.001) showed significant associations with functional outcomes. However, demographic factors, fracture patterns, and surgical approaches did not significantly influence results.
Conclusion: Surgical management of displaced acetabular fractures yields favorable outcomes in the majority of cases. The quality of reduction is the most critical determinant of functional recovery, emphasizing the importance of anatomical reduction as the primary surgical objective. Marginal impaction and initial displacement magnitude are additional important predictors of outcome. These findings highlight key factors that surgeons should consider when managing these complex injuries to optimize patient recovery.
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