A prospective study on functional outcome of surgical management of acetabular fractures

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.