Clinical trial NCT06338228: A New Decisional Tree for the Management of Acetabular Fractures : Monocentric Observational Study
Official title: A New Decisional Tree for the Management of Acetabular Fractures : Monocentric Observational Study
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Management of Acetabular Fractures
Lead sponsor: University Hospital, Grenoble
Sponsor class: OTHER
First posted: 2024-03-29
Enrollment: 250
Sex: ALL
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: All patients managed between 01/01/2020 and 01/01/2023 for an acetabular fracture in our trauma center are included in this single-center retrospective study.

The epidemiological data, the pre-operative management, the fracture patterns according to the Letournel and AO/OTA classification, the operative data and the radiological criteria (X-rays and CT scans) are retrospectively collected and analyzed.

Brief summary: Acetabular fractures are challenging fractures to treat. Many fracture patterns occur, in a deep anatomical area surrounded by numerous vascular and nervous elements, generally in a polytraumatic context . A reduction with less than 2 mm of incongruence is generally considered acceptable, limiting post-operative osteoarthritis that could rapidly require total hip arthroplasty. Due to the long learning curve, this surgery is limited to large reference centers

. In the last twenty years, the main series published in the literature are small series due to the rarity of the fractures and their trauma context (loss of follow-up, polytrauma patients...). The large variety of fracture patterns according to the Letournel classification creates a spread in patient distribution and decreases the power of statistical analysis. That is the reason why big series are rare and only a few of them allow significant conclusions . The other studies are meta-analyses with their limitations

The lack of consensus makes it difficult to interpret the results between series, so the investigators developed a decision tree to address this knowledge gap.

The aim of this study is to assess and compare the results of a decisional tree for acetabular fracture in a large cohort of patients from a well-known experimental trauma center.


Eligibility criteria: Inclusion Criteria:

* Adult patient at the time of injury
* Acetabular fracture
* Pre-operative standard X-ray image
* Pre-operative CT image
* Post-operative X-ray standard image (AP-alar and obturator views)
* Post-operative CT scan.
* Willingness and ability to participate in the study

Exclusion Criteria:

* Ipsilateral fracture femoral and/or associated pelvic ring fracture (Floating Hip C or B)
* Pregnant, lactating women
* Subject under administrative or judicial supervision

Primary outcomes:
measure: The main objective of the study is to evaluate and compare the results of a decision tree for the management of acetabulum fractures (also called acetabulum) in a large cohort of patients from the trauma center at Grenoble University Hospital
timeFrame: 1 year
Secondary outcomes:
measure: Define the prognostic factors associated with poor clinical outcomes and total hip replacement surgery
timeFrame: 1 year
measure: Compare clinical and radiological findings with the literature
timeFrame: 1 year
measure: Compare clinical and radiological findings with the literature
timeFrame: 1 year
measure: Compare clinical and radiological findings with the literature
timeFrame: 1 year
measure: Compare clinical and radiological findings with the literature
timeFrame: 1 year
measure: Compare clinical and radiological findings with the literature
timeFrame: 1 year
measure: Propose a new assessment of the traumatic hip joint based on PROMs (Patient Reported Outcomes Measures) via a dedicated digital application (Orthense by Digikare)
timeFrame: 1 year
measure: Evaluation of Outcomes and Complications of Early Weight Bearing in Older Adults
timeFrame: 1 year
Other outcomes:
Locations:
city: Grenoble
country: France
facility: Grenoble Alpes University Hospital,La tronche
Study officials:
affiliation: Grenoble Alpes University Hospital
name: Mehdi PI BOUDISSA, Pr
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res. 1980 Sep;(151):81-106.
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