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Results of operative treatment of acetabular fractures from the Third World—how local factors affect the outcome

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Abstract

The objective of this study was to assess the outcome of operations on acetabular fractures from a developing country in the presence of locally available facilities. Sixty-three acetabular fractures were assessed at an average follow up of 52.94 months after operation. Twenty-six patients operated upon in the first three years and 37 operated thereafter were separately studied to discover the effect of the learning curve. Regarding the fractures, 47 of 63 (74.6%) had excellent/good results (Harris Hip Score>80). The complications included broken drill bit in eight patients (12.69%), deep infection and heterotopic ossification in five patients (7.93%), avascular necrosis and sciatic nerve palsy in two patients (3.17%) and implant failure in one patient (1.58%). The results collected during the learning curve were inferior in the complex fractures (p value<0.001). Complications were common in patients opting for local implants and in those operated after over 2 weeks delay.

Résumé

Le but de ce travail est d’évaluer le traitement des fractures de l’accétabulum dans un pays développé. Matériel et méthode : 63 fractures de l’accétabulum ont été suivies en moyenne pendant 52,94 mois. 26 patients ont été opérés dans les trois premières années de notre expérience et les 37 autres patients opérés trois ans après que nous ayons commencé ce type de traitement, ceci afin d’évaluer de façon séparée les effets de notre courbe d’apprentissage. 47 sur 63 (74,6%) ont eu un excellent/bon résultat avec un score de Harris supérieur à 80. Les complications ont été les suivantes : 8 fractures de mèches (12,69%), 5 infections profondes (7,93%) et 7 ossifications hétérotypiques (7,93%), 2 nécroses de la tête fémorale et 2 paralysies sciatiques (3,17%) une dans chaque groupe. Enfin, un débricolage chez un patient (1,58%). Les résultats selon la courbe d’apprentissage sont moins bons dans des fractures complexes (p < 0.001) en début de pratique. Les complications sont plus habituelles chez les patients ayant bénéficié de la mise en place d’implants ou chez ceux opérés après 2 semaines de délai.

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Authors and Affiliations

  1. Department of Orthopaedics, Government Medical College Hospital, Sector 32, Chandigarh, India, 160030

    Ravi K. Gupta, Harmeet Singh, Bias Dev, Rajeev Kansay, Parmanand Gupta & Sudhir Garg

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  1. Ravi K. Gupta
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  2. Harmeet Singh
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  3. Bias Dev
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  4. Rajeev Kansay
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  5. Parmanand Gupta
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  6. Sudhir Garg
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Correspondence to Ravi K. Gupta.

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Gupta, R.K., Singh, H., Dev, B. et al. Results of operative treatment of acetabular fractures from the Third World—how local factors affect the outcome. International Orthopaedics (SICOT) 33, 347–352 (2009). https://doi.org/10.1007/s00264-007-0461-3

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  • DOI: https://doi.org/10.1007/s00264-007-0461-3

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