A New Decisional Tree for the Management of Acetabular Fractures : Monocentric Observational Study

University Hospital, Grenoble250 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

250

Conditions

Management of Acetabular Fractures

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

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

Clinical results according to the Postel-Merle d'Aubigné score (PMA)

Time frame: 1 year

Secondary Outcomes

Define the prognostic factors associated with poor clinical outcomes and total hip replacement surgery

Prognostic factors from operative data

Time frame: 1 year