Comparison of Percutaneous Screw Fixation to Open Reduction and Internal Fixation in Acetabular Fractures: A Matched Pair Study Regarding the Short-Term Rate of Conversion to Total Hip Arthroplasty and Functional Outcomes.
Stephanie EinhornAndreas HöchGeorg OsterhoffChristoph JostenChristian KleberPhilipp PierohPublished in: Journal of clinical medicine (2023)
Closed reduction and percutaneous internal fixation (CRPIF) for acetabular fractures was introduced as a less invasive alternative to open reduction and internal fixation (ORIF) for moderately displaced fractures. Currently, comparisons of ORIF and CRPIF outcomes are rare. Twenty-three patients treated with CRPIF were matched with patients treated with ORIF based on sex, age, and fracture classification. Surgery-dependent and -independent factors of the in-hospital stay, the conversion rate to total hip arthroplasty (THA), and quality of life were assessed. The ORIF group had a higher preoperative fracture step ( p = 0.04) and gull wing sign ( p = 0.003) compared with the CRPIF group. Postoperatively, the gap and step size were not significantly different between the groups ( p > 0.05). CRPIF required less time ( p < 0.0001) and transfusions ( p = 0.009) and showed fewer complications ( p = 0.0287). Four patients were converted to THA (CRPIF, n = 1; ORIF, n = 3; p = 0.155) because of posttraumatic osteoarthritis. Functional outcomes and pain were similar in both groups ( p > 0.05). The present study revealed less blood loss and a lesser extent of reduction in patients treated with CRPIF than in those treated with ORIF. The rates of conversion to THA and functional outcomes did not differ between CRPIF and ORIF. CRPIF appeared to be a valuable treatment option for selected patients.
Keyphrases
- total hip arthroplasty
- minimally invasive
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- rheumatoid arthritis
- chronic pain
- type diabetes
- ultrasound guided
- acute coronary syndrome
- risk factors
- patient reported outcomes
- total knee arthroplasty
- coronary artery bypass
- spinal cord
- combination therapy
- hip fracture
- replacement therapy