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Background <p>Displaced acetabulum fracture is one of the most difficult traumatic injuries to be managed. It has a bearing on the patients’ life in the long-term. The ability to return to pre-injury quality of life (QoL) is of major importance after acetabular fracture fixation, which in turn depends on quality of fracture reduction. The purpose of this study is to ascertain the effect of the quality of reduction on patients’ QoL.</p> Hypothesis <p>The patients with non-anatomic reduction of acetabular fracture will have a poorer QoL and higher complication rate as compared to anatomic reduction group.</p> Method <p>A retrospective review of all the patients with acetabular fracture who were managed surgically was conducted. The patients were divided into two groups–anatomic reduction (n = 79) and non-anatomic reduction (n = 47) after reviewing the post-operative Computed Tomography (CT) scans. QoL parameters using various patient-reported outcomes measures (PROMs) like, VAS score for hip pain, Modified Harris Hip Score, Short-form 12 questionnaire, UCLA activity score and Patient satisfaction score were compared between the two groups at a minimum follow-up of 2&#xa0;years. Complications like conversion to Total hip arthroplasties (THA) due to development of arthritis or AVN of femoral head, were also evaluated.</p> Results <p>Modified Harris Hip score (mHHS) for the affected hip [61.5 ± 7.5 (59.9–63 .2) vs 57.1 ± 7.8 (54.8–59.3)], SF-12 (both PCS [50.5 ± 9.9 (48.4–52.7) vs 44.3 ± 8 (42–46.5)] and MCS [53.3 ± 7.8 (51.6–55.1) vs 48.3 ± 9.7 (45.6–51.1)]), UCLA activity score [4.6 ± 1.1 (4.4–4.8) vs 4.1 ± 0.9 (3.8–4.3)], and patient satisfaction scores [47.2 ± 4.5 (46.2–48.2) vs 45.1 ± 5.8 (43.4–46.8)] were significantly (<i>p</i> &lt; 0.05) better in those with anatomic reduction. However, post-operative VAS was comparable in both groups. The conversion rate to THA was not found to be different between the two groups. Multivariate analysis found reduction quality to be an independent factor affecting patients’ QoL.</p> Conclusion <p>Quality of fracture reduction is one of the most important factors for determining the clinical outcome of the patient. An anatomic reduction not only provides better functionality to the hip; it also results in a better quality of life for the patient.</p> <p><b>Level of Evidence:</b> III, Retrospective cohort study.</p>

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Does non-anatomic reduction and fixation of acetabular fractures affect the post-operative quality of life?—a single center, five years, retrospective analytical study

  • 期刊论文

  • 发表日期：

    2025年10月15日

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  • Arghya Kundu Choudhury,
  • Kshitij Gupta,
  • Surabhi Das,
  • Chanakya P V,
  • Tarun Goyal,
  • Balgovind S Raja,
  • Vivek Singh,
  • Bhaskar Sarkar,
  • Roop Bhushan Kalia

摘要

Background

Displaced acetabulum fracture is one of the most difficult traumatic injuries to be managed. It has a bearing on the patients’ life in the long-term. The ability to return to pre-injury quality of life (QoL) is of major importance after acetabular fracture fixation, which in turn depends on quality of fracture reduction. The purpose of this study is to ascertain the effect of the quality of reduction on patients’ QoL.

Hypothesis

The patients with non-anatomic reduction of acetabular fracture will have a poorer QoL and higher complication rate as compared to anatomic reduction group.

Method

A retrospective review of all the patients with acetabular fracture who were managed surgically was conducted. The patients were divided into two groups–anatomic reduction (n = 79) and non-anatomic reduction (n = 47) after reviewing the post-operative Computed Tomography (CT) scans. QoL parameters using various patient-reported outcomes measures (PROMs) like, VAS score for hip pain, Modified Harris Hip Score, Short-form 12 questionnaire, UCLA activity score and Patient satisfaction score were compared between the two groups at a minimum follow-up of 2 years. Complications like conversion to Total hip arthroplasties (THA) due to development of arthritis or AVN of femoral head, were also evaluated.

Results

Modified Harris Hip score (mHHS) for the affected hip [61.5 ± 7.5 (59.9–63 .2) vs 57.1 ± 7.8 (54.8–59.3)], SF-12 (both PCS [50.5 ± 9.9 (48.4–52.7) vs 44.3 ± 8 (42–46.5)] and MCS [53.3 ± 7.8 (51.6–55.1) vs 48.3 ± 9.7 (45.6–51.1)]), UCLA activity score [4.6 ± 1.1 (4.4–4.8) vs 4.1 ± 0.9 (3.8–4.3)], and patient satisfaction scores [47.2 ± 4.5 (46.2–48.2) vs 45.1 ± 5.8 (43.4–46.8)] were significantly (p < 0.05) better in those with anatomic reduction. However, post-operative VAS was comparable in both groups. The conversion rate to THA was not found to be different between the two groups. Multivariate analysis found reduction quality to be an independent factor affecting patients’ QoL.

Conclusion

Quality of fracture reduction is one of the most important factors for determining the clinical outcome of the patient. An anatomic reduction not only provides better functionality to the hip; it also results in a better quality of life for the patient.

Level of Evidence: III, Retrospective cohort study.