ANALYSIS OF THE SEGMENTAL IMPACTION OF FEMORAL HEAD FOLLOWING AN ACETABULAR FRACTURE SURGICALLY MANAGED

Rodrigo Pereira Guimarães; Camila Cohen Kaleka; Carina Cohen; Daniel Daniachi; Nelson Keiske Ono; Emerson Kiyoshi Honda; Giancarlo Cavalli Polesello; Walter Riccioli

doi:10.1016/S2255-4971(15)30274-3

ANALYSIS OF THE SEGMENTAL IMPACTION OF FEMORAL HEAD FOLLOWING AN ACETABULAR FRACTURE SURGICALLY MANAGED

Rev Bras Ortop. 2015 Dec 8;44(5):427-31. doi: 10.1016/S2255-4971(15)30274-3. eCollection 2009 Jan.

Authors

Rodrigo Pereira Guimarães¹, Camila Cohen Kaleka², Carina Cohen², Daniel Daniachi³, Nelson Keiske Ono⁴, Emerson Kiyoshi Honda⁵, Giancarlo Cavalli Polesello⁶, Walter Riccioli⁷

Affiliations

¹ Education Teacher, FCMSCSP; Assistant, Hip Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil.
² Resident, Department of Orthopedics and Traumatology, FCMSCSP, São Paulo, Brazil.
³ Orthopedist; Volunteer, Hip Group, Department of Orthopedics and Traumatology, FCMSCSP, São Paulo, Brazil.
⁴ Assistant Professor and Physician, FCMSCSP; Head, Hip Group, Department of Orthopedics and Traumatology, FCMSCSP, São Paulo, Brazil.
⁵ Education Teacher and Physician, FCMSCSP; Senior Member, Hip Group, Department of Orthopedics and Traumatology FCMSCSP, São Paulo, Brazil.
⁶ Assistant Professor and Physician, FCMSCSP; Assistant, Hip Group, Department of Orthopedics and Traumatology, FCMSCSP, São Paulo, Brazil.
⁷ Orthopedist; Assistant, Hip Group, Department of Orthopedics and Traumatology, FCMSCSP, São Paulo, Brazil.

Abstract

Objective: Correlate the postoperative radiographic evaluation with variables accompanying acetabular fractures in order to determine the predictive factors for segmental impaction of femoral head.

Methods: Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation. Within approximately 35 years, 596 patients were treated for acetabular fractures; 267 were followed up for at least two years. The others were excluded either because their follow up was shorter than the minimum time, or as a result of the lack of sufficient data reported on files, or because they had been submitted to non-surgical treatment. The patients were followed up by one of three surgeons of the group using the Merle d'Aubigné and Postel clinical scales as well as radiological studies.

Results: Only tow studied variables-age and amount of postoperative reductionshowed statistically significant correlation with femoral head impaction.

Conclusions: The quality of reduction-anatomical or with up to 2mm residual deviation-presents a good radiographic evolution, reducing the potential for segmental impaction of the femoral head, a statistically significant finding.

Keywords: Acetabulum/injuries; Acetabulum/surgery; Femur head necrosis; Hip fractures.