[Clinical outcome of open reduction and internal fixation with digastric trochanteric flip osteotomy for acetabular posterior wall fracture with hip dislocation]

Objective: To evaluate the clinical outcome of open reduction and internal fixation via digastric trochanteric flip osteotomy for acetabular posterior wall fracture with hip dislocation. Methods: From January 2014 to December 2016 a total of 39 patients who suffered posterior wall acetabular fracture and hip dislocation and treated in Beijing Jishuitan Hospital were included in this retrospective study. All the patients were divided into two groups according to surgery type. There were 22 cases in osteotomy group who underwent digastric trochanteric flip osteotomy (DTFO) via Kocher-Langenbeck (K-L) approach, while 17 cases in control group who only received surgery via (K-L) approach. The Matta scale was used to evaluate fracture reduction, while functional recovery scale (FRS) and Euro-Quality of 5 Dimension (EQ-5D) were applied to measure the clinical effect. Results: The baseline characteristics were similar for both groups and the mean follow-up period was (48±11) months. All the surgeries were performed successfully. The blood loss (t=1.52, P=0.12), bed days (t=1.22, P=0.25), complication rate (χ²=2.02, P=0.16) and operation time (t=1.31, P=0.23) showed no significant difference between the 2 groups (P>0.05). The fracture reduction (χ²=0.05, P=0.81) were similar between the 2 groups but the excellent rate were higher in osteotomy group. According to evaluation scales the FRS score and EQ-5D index favored osteotomy group(85±13 vs 80±15 and 0.86±0.12 vs 0.80±0.17, respectively, t=2.87, 3.47, both P<0.05). Conclusion: K-L approach with DTFO can provide clearier surgical field which is convenient for procedure, and compared to K-L approach the clinical effect is more satisfactory.