Abstract:
Background:
Acetabular fractures represent complex injuries that present
significant management challenges. This prospective study evaluates the
functional outcomes of surgical management of acetabular fractures at a tertiary
care center and identifies factors influencing these outcomes.
Methods:
Thirty-one patients with acetabular fractures who underwent surgical
management between 2023 and 2025 were enrolled in this prospective study.
Fractures were classified according to the Judet-Letournel system, and functional
outcomes were assessed using the modified Merle d’Aubigne score at
presentation, 6 weeks, 3 months, and 6 months post-surgery. Demographic data,
fracture characteristics, surgical approaches, complications, and associated
injuries were documented. Statistical analysis was performed to identify factors
associated with functional outcomes.
Results:
The study cohort comprised predominantly young adult males (71%),
with road traffic accidents being the primary mechanism of injury (71%).
Posterior column fractures and anterior column fractures with associated pubic
rami fractures (25.8% each) were the most common patterns, followed by
posterior wall fractures (19.4%). Associated posterior hip dislocations were
present in 25.8% of cases. The Kocher-Langenbeck approach was most frequently
employed (45.2%), followed by the modified Stoppa approach (32.3%).
Functional assessment revealed progressive improvement, with all patients
demonstrating poor scores at presentation, progressing to 51.6% excellent and
48.4% moderate outcomes by 6 months. Complications were observed in 19.4%
of patients, with hip stiffness being the most common (9.7%). Age, fracture
pattern, associated dislocation, surgical approach, and post-surgery follow-up
significantly influenced functional outcomes, while the presence of complications
also showed a significant association (p=0.03).
Conclusion:
Surgical management of acetabular fractures yields favorable
functional outcomes, with progressive improvement over time. Most
demographic and fracture characteristics significantly influenced outcomes, and
the results support the efficacy of tailored surgical approach selection and
meticulous technique. The findings highlight the importance of extended
rehabilitation and careful management of complications to optimize functional
recovery.
