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

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

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.

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