Comparison of open reduction and internal fixation in treatment of delayed and early acetabular fractures

To retrospectively compare the clinical efficacy of open reduction and internal fixation (ORIF) in treating delayed and early acetabular fractures. Ninety cases with delayed (n = 35) and early acetabular fractures (n = 55) undergoing ORIF between September 2009 and March 2013 were retrospectively analyzed. Patients in the delayed acetabular fracture group underwent ORIF at 22-65 d (mean 36 d) after injury and those in the early acetabular fracture group received ORIF at 3-20 d (mean: 8.1 d) after trauma. Ilioinguinal, Kocher-Langenbenk or combined approaches were adopted according to the types of fracture. Fracture reduction was evaluated using the Matta standard. Clinical efficacy was assessed by Matta modified D'Aubigne and Postel grading system. Postoperative follow-up endured for 18-36 months, 25 months on average. In the delayed fracture group, 15 (43%) cases had anatomical reduction, 17 (49%) were satisfied with the reduction whereas 3 (9%) were unsatisfied. In the early fracture group, 35 (64%) cases had anatomical reduction, 19 (35%) cases were satisfied with the reduction and only 1 (3%) patient was unsatisfied with no statistical significance between two groups. In the delayed fracture group, 16 cases obtained excellent outcomes, 15 good, 2 average and 2 had poor results, and 35 excellent, 18 good, 1 average and 1 poor in the early fracture group. Excellent rate did not significantly differ between two groups. Satisfactory and excellent rates of ORIF did not significantly differ between two groups. ORIF is an effective and feasible treatment of delayed acetabular fracture.