TITLE

Outcomes of Posterior Wall Fractures of the Acetabulum Treated Nonoperatively After Diagnostic Screening with Dynamic Stress Examination Under Anesthesia

AUTHOR(S)
Grimshaw, Charles S.; Moed, Berton R.
PUB. DATE
December 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;12/1/2010, Vol. 92-A Issue 17, p2792
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Dynamic stress fluoroscopy with the patient under general anesthesia has been advocated as a clinical measure of hip stability and congruity in patients with a posterior wall acetabular fracture. The purpose of this study was to establish the predictive value of the dynamic stress fluoroscopic examination for these fractures by evaluating clinical and radiographic outcomes after nonoperative treatment of fractures found to be stable with this examination. Methods: Twenty-one consecutive patients with an acute posterior wall fracture of the acetabulum who were shown to have a stable hip joint by dynamic stress fluoroscopy while they were under general anesthesia were treated non- operatively. At the time of follow-up, the patients underwent clinical and/or radiographic evaluation. Results: Clinical follow-up was performed for eighteen patients at a minimum of two years after injury, at which time the average modified Merle d'Aubigné score was very good, with no one having less than a good clinical outcome. Fifteen of these eighteen patients had radiographic evaluation at a minimum of two years, and all were found to have a congruent joint with a normal joint space and no evidence of posttraumatic arthritis. Conclusions: Hip joint stability determined with dynamic stress fluoroscopy with the patient under general anesthesia after a posterior wall acetabular fracture is predictive of hipjoint congruity, an excellent radiographic outcome, and a good-to-excellent early clinical outcome after nonoperative treatment. Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
55819340

 

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