Open reduction and internal fixation of acetabulum fractures: Does timing of surgery affect blood loss and or time?

Objectives: The purpose of this study was to investigate the timing of surgical intervention for fractures of the acetabulum and its influence on perioperative factors. Design: Retrospective review. Setting: Level I trauma center. Patients: Two hundred eighty-eight consecutive patients who sustained either posterior wall (PW), associated both column (ABC), or anterior column posterior hemitransverse (ACPHT) acetabulum fractures were included in the study. Intervention: One hundred seventy-six PW fractures were treated through a Kocher-Langenbeck approach, and 112 ABC/ACPHT fractures were treated through an anterior intrapelvic approach. Main Outcome Measurements: Estimated blood loss (EBL), operative time. Results: EBL (800 vs. 400 mL), operative time (270 vs.154 minutes), and hospital stay (11 vs. 7 days) were greater for the ABC/ACPHT fractures compared with the PW fractures. When comparing early (≤48 hours) versus late (>48 hours) treatment of PW fractures, there was no difference in EBL (400 vs. 400 mL, P = 0.37) or operative time (150 vs. 156 minutes, P = 0.50). In comparison of early versus late treatment of ABC/ACPHT fractures, no significant difference was noted in EBL (725 vs. 800 mL, P = 0.30) or operative time (258.5 vs. 272 minutes, P = 0.21). Conclusions: We found no advantage or disadvantage in terms of EBL or operative time for early (≤48 hours) versus late (>48 hours) fixation for either PW or ABC/ACPHT acetabular fractures.