![]() Intraoperative acetabular fractures are rare complications of THA, and most commonly occur during the implantation of the acetabular components. All the latest x-ray showed that the fracture did not move, and there is no translucent line formed in the acetabular cup bone interface. The HHS score increased from 30.8 ± 9.7 preoperatively to 90.2 ± 4.2 postoperatively. Six patients(25%)with Ankylosing Spondylitis had fractures, 4 in the anterior wall, and 1 in the anterior column, because the patient with hip joint fusion needs a to pre-osteotomy before the dislocation. In 17(70.8%) of these patients, the fracture was noted during the impaction of the real acetabular component. The fracture rate associated with uncemented components was 0.49%. We evaluated the anatomic locations, causes, treatments, and outcome of the fractures to study the treatment method and effect of intraoperative acetabular fracture during operation. All patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically with serial X-rays which follow up for a mean period of 34.0 ± 12.6 months. In 4 patients(16.7%), the acetabular components were judged to be stable despite the fracture and no additional treatment was performed. Two patients’ femoral heads were used as a graft. Twenty patients(83.3%)underwent supplemental screw fixation, of which 2 patients were treated with steel plate fixation. Twenty-four patients(16 females and 8males)were all treated with a posterolateral approach using uncemented components. We retrospectively reviewed the records in our Total Joint Registry Database and found that 24 patients (24 hips) had sustained intraoperative acetabular fractures. Methodsīetween 2015 to 2018, 4888 primary THA were enrolled. The previous reports have lacked a sufficiently large number of subjects to allow for an analysis of the causes and appropriate treatment of this problem. To obtain optimal reduction of the acetabulum, initial accurate reduction of the posterior pelvic lesion appears to be necessary.Intraoperative acetabular fracture(IAF) is a rare complication of primary total hip arthroplasty(THA). Patients with combined pelvic and acetabular fractures represent a serious injury that includes the resuscitative challenges of pelvic injuries coupled with the difficulties of precise reduction of acetabular fractures. ![]() Multiple regression analysis revealed that the amount of postoperative posterior pelvic displacement, Type B2 acetabular fractures, and patient age were significant predictors of the amount of residual acetabular displacement found postoperatively. The mean postoperative displacement of acetabular fracture reduction was 2.2 mm as evaluated by radiographs. Sixty-eight patients underwent surgical intervention at a mean time of 5.7 days. The most frequent injury combination was a transverse-type acetabular fracture with an associated ipsilateral anterior disruption of the sacroiliac joint. Transverse-type acetabular fractures patterns (OTA 62.B1 and B2) accounted for 61.2% of all acetabular fractures in the combined group. In the combined group, the most common pelvic fracture patterns were OTA 61.B1 and B2. ![]() Patients in the combined group were significantly more injured as compared with the displaced acetabular fracture control group with regard to Injury Severity Score (P < 0.001), systolic blood pressure (P < 0.001), and packed red blood cells (P < 0.001). Eighty-two patients with an isolated unstable pelvic injury and 82 patients with an isolated displaced acetabular fracture were chosen from the same study period to act as control groups. ![]() To determine the independent factors influencing the postoperative residual displacement of the acetabulum, multiple linear regression analysis was used.īetween January 1, 1998, and December 31, 2007, there were 1612 patients with either pelvic or acetabular fractures requiring admission to our institution, of which 82 (5.1%) had the combination of an unstable pelvic injury (Orthopaedic Trauma Association 61 Types B/C) and a displaced acetabular fracture (OTA 62). Age- and sex-matched control groups of patients with pure pelvic fractures and pure acetabular fractures were compared with the combined injury group to assess injury severity characteristics. The data collected included patient demographics, fracture classification, Injury Severity Score, systolic blood pressure on arrival, amount of packed red blood cells transfused, time to operation, perioperative complications, and radiographic outcomes. ![]() We hypothesize that this combination of injuries affects not only the postinjury hemodynamics of the patient, but the outcome of subsequent acetabular fracture treatment. To describe the clinical characteristics of combined injuries of the pelvis and acetabulum, which have not been previously described. ![]()
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