Function Outcome of Impaction Injuries in Acetabular Fractures

Study Overview
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Brief Summary
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Is the anatomical reduction of osteochondral impaction in the acetabular fractures will improve the functional outcome? Despite the increasing amount of literature related to the management of anteromedial dome impactions and marginal impactions, there are still remaining issues and controversies pertaining mainly to the exact anatomy and location of the lesion, the best method of reduction, the need and type of subchondral void filling, the best method of stabilization, the need of reduction in elderly population and its true value as an outcome prognostic factor.

Detailed Description
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The reduction of the impacted fragment done through many ways and techniques , all acetabular approaches can be used to reach to the impacted part or through independent cortical window, The impacted part can be reached through the fracture itself as in marginal impaction through the posterior wall and in anteromedial impaction through the quadrilateral plate. Then using a bone graft as a void filling which can be taken from iliac bone or greater trochanter. Post-operative x-rays and computed tomography scan will be done to all patients , Radiological grading immediate post-operative and at the last follow-up according to Matta , Heterotopic ossification will be classified according to the Brooker classes on an Anteroposterior radiograph, Posttraumatic arthritis will be evaluated according to the method by Kellgren and Lawrence, functional outcome will be assessed according to Merle D'Aubigne and Postel scoring which was modified by Matta, Avascular necrosis of hips will be classified according to Ficat and Arlet classification.

Official Title
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Short-Term Outcome of Surgical Treatment of Osteochondral Impaction in Acetabular Fractures

Conditions
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Acetabular Fracture

Intervention / Treatment
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* Other: No intervention. Observational study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Traumatic Osteochondral impaction injuries of the acetabulum (marginal and dome ). Pure impaction without cortical interruption Closed fractures. Skeletally mature (adults and elderly). Exclusion Criteria: Fractures in skeletally immature patients. Pathological fractures . Associated proximal Hip fractures. Open acetabular Fractures. Fractures more than 3 weeks

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention. Observational study|Follow up of the function of the hip after reduction of the impacted fragment which associated with acetabular fractures|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| modified Merle d'Aubigne and Postel scoring | The modified Merle D'Aubigné clinical hip score is the most generally accepted clinical grading system for evaluating the results of acetabular fracture treatment , which evaluates pain, gait and mobility, on a scale. | 6th month |