Achieving anatomic acetabular fracture reduction - When is the best time to operate?

Steven K. Dailey, Caleb T. Phillips, Joseph M. Radley, Michael T. Archdeacon

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We hypothesize that earlier operative intervention for acetabular fractures improves the probability of achieving an anatomic reduction. Design: Retrospective review. Setting: Academic level I trauma center. Patients/Participants: Six hundred fifty acetabular fractures treated through open reduction and internal fixation (ORIF) between September 2001 and February 2014. Intervention: Acetabular fracture ORIF. Main Outcome Measurements: Reduction quality was assessed through postoperative radiographs. Displacement of ≤1 mm was considered an anatomic reduction, 2-3 mm imperfect, and >3 mm poor. Results: Anatomic reductions were observed in 85% (n 553) of cases, imperfect reductions in 11% (n 74) of cases, and poor reductions in 4% (n 23) of cases. Patients with anatomic reductions had significantly shorter times from injury to ORIF [odds ratio (OR) interval] (median, 3 d) when compared with either imperfect (median, 4.5 days, P 0.02) or poor reductions (median, 7 days, P < 0.001) reductions. The OR interval of imperfect reductions was also significantly shorter than that of poor reductions (P 0.02). Logistic regression analysis demonstrated that OR interval had an effect of -0.12, meaning that the log odds of anatomic reduction decreases by 0.12 with each day from injury to ORIF. Conclusion: The interval from injury to operative fixation of acetabular fractures affects reduction quality. Earlier intervention improves the probability of achieving an anatomic reduction; therefore, ORIF should be performed as early as possible, provided the patient is optimized for surgery. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)426-431
Number of pages6
JournalJournal of orthopaedic trauma
Volume30
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Keywords

  • ORIF
  • acetabulum
  • reduction quality
  • surgical timing

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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