Surgical Stabilization of Pelvic and Acetabular Fractures: A Review on the Determinants of Clinical Outcomes

Aim: Pelvic and acetabular fractures are associated with high-energy trauma. The aim of this study was to identify factors that are associated with specific clinical outcomes following treatment for these fractures. Methods: A consecutive series of 30 patients who had surgical intervention for either pelvic or acetabular fractures formed the sample for this study. Clinical variables reviewed were: age, associated injuries, number of surgical procedures, time to surgery and post-operative complications. Clinical outcomes were assessed using Matta’s grading of postoperative fracture reduction alignment, and functional outcomes were graded using D'Aubigne & Postel’s Hip scoring system. Results: Study subjects included twelve pelvic fractures and eighteen acetabular fractures. Patients older than 50 years of age had poorer hip scores despite surgery. Earlier fracture fixation (within five days) was associated with better hip scores. Patients with acetabular fractures generally had better functional outcomes than patients with pelvic fractures (mean hip score 15.0 vs. 13.5). Closer anatomical reduction of acetabular fractures was associated with better functional outcome. Conclusion: Improved clinical outcomes are associated with younger age, fewer concomitant injuries, shorter time interval to surgery and more closely approximated anatomical fracture reduction.