Function Outcome of Impaction Injuries in Acetabular Fractures

NCT03152266 | Completed

• 1 other identifier: OCIA
• Study Type: observational
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Is the anatomical reduction of osteochondral impaction in the acetabular fractures will improve the functional outcome? Despite the increasing amount of literature related to the management of anteromedial dome impactions and marginal impactions, there are still remaining issues and controversies pertaining mainly to the exact anatomy and location of the lesion, the best method of reduction, the need and type of subchondral void filling, the best method of stabilization, the need of reduction in elderly population and its true value as an outcome prognostic factor.

Conditions

Acetabular Fracture

Outcome Measures

Primary Outcomes (1)

• modified Merle d'Aubigne and Postel scoring

  The modified Merle D'Aubigné clinical hip score is the most generally accepted clinical grading system for evaluating the results of acetabular fracture treatment , which evaluates pain, gait and mobility, on a scale.

  6th month

Interventions

No intervention. Observational study OTHER

Follow up of the function of the hip after reduction of the impacted fragment which associated with acetabular fractures

Eligibility Criteria

• Age: 15 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients will be admitted at emergency department of assiut university hospital , ATLS protocol will be applied , preoperaive plane xray (anteroposterior and CT scan will be done)post operative x rays and CT scan will be done to all patients , Radiological grading just post-operative at the last follow-up according to Matta, Heterotopic ossification was classified according to the Brooker classes on an AP radiograph, Posttraumatic arthritis was evaluated according to the method by Kellgren and Lawrence, functional outcome will be assessed according to Merle d'Aubigne and Postel scoring which was modified by Matta, Avascular necrosis of hips was classified according to Ficat and Arlet classification

You may qualify if:

• Traumatic Osteochondral impaction injuries of the acetabulum (marginal and dome ).
• Pure impaction without cortical interruption
• Closed fractures.
• Skeletally mature (adults and elderly).

You may not qualify if:

• Fractures in skeletally immature patients.
• Pathological fractures .
• Associated proximal Hip fractures.
• Open acetabular Fractures.
• Fractures more than 3 weeks

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Assiut faculty of medicine

Asyut, 71111, Egypt

Location

Related Publications (21)

• Martins e Souza P, Giordano V, Goldsztajn F, Siciliano AA, Grizendi JA, Dias MV. Marginal impaction in posterior wall fractures of the acetabulum. AJR Am J Roentgenol. 2015 Apr;204(4):W470-4. doi: 10.2214/AJR.14.12451.

  PMID: 25794097 BACKGROUND

• Wu XB, Wang MY, Zhu SW, Cao QY, Wu HH. [Marginal impaction in acetabular fractures]. Zhonghua Wai Ke Za Zhi. 2003 Apr;41(4):289-91. Chinese.

  PMID: 12882675 BACKGROUND

• Leucht P, Castillo AB, Bellino MJ. Comparison of tricalcium phosphate cement and cancellous autograft as bone void filler in acetabular fractures with marginal impaction. Injury. 2013 Jul;44(7):969-74. doi: 10.1016/j.injury.2013.04.017. Epub 2013 May 14.

  PMID: 23684351 BACKGROUND

• Moed BR, WillsonCarr SE, Watson JT. Results of operative treatment of fractures of the posterior wall of the acetabulum. J Bone Joint Surg Am. 2002 May;84(5):752-8. doi: 10.2106/00004623-200205000-00008.

  PMID: 12004016 BACKGROUND

• Bhandari M, Matta J, Ferguson T, Matthys G. Predictors of clinical and radiological outcome in patients with fractures of the acetabulum and concomitant posterior dislocation of the hip. J Bone Joint Surg Br. 2006 Dec;88(12):1618-24. doi: 10.1302/0301-620X.88B12.17309.

  PMID: 17159175 BACKGROUND

• Giannoudis PV, Kanakaris NK, Delli Sante E, Morell DJ, Stengel D, Prevezas N. Acetabular fractures with marginal impaction: mid-term results. Bone Joint J. 2013 Feb;95-B(2):230-8. doi: 10.1302/0301-620X.95B2.30548.

  PMID: 23365034 BACKGROUND

• Moed BR, Yu PH, Gruson KI. Functional outcomes of acetabular fractures. J Bone Joint Surg Am. 2003 Oct;85(10):1879-83. doi: 10.2106/00004623-200310000-00002.

  PMID: 14563792 BACKGROUND

• Ugino FK, Righetti CM, Alves DP, Guimaraes RP, Honda EK, Ono NK. Evaluation of the reliability of the modified Merle d'Aubigne and Postel Method. Acta Ortop Bras. 2012;20(4):213-7. doi: 10.1590/S1413-78522012000400004.

  PMID: 24453605 BACKGROUND

• Kreder HJ, Rozen N, Borkhoff CM, Laflamme YG, McKee MD, Schemitsch EH, Stephen DJ. Determinants of functional outcome after simple and complex acetabular fractures involving the posterior wall. J Bone Joint Surg Br. 2006 Jun;88(6):776-82. doi: 10.1302/0301-620X.88B6.17342.

  PMID: 16720773 BACKGROUND

• Manson T, Schmidt AH. Acetabular Fractures in the Elderly: A Critical Analysis Review. JBJS Rev. 2016 Oct 4;4(10):e1. doi: 10.2106/JBJS.RVW.15.00090.

  PMID: 27792674 BACKGROUND

• Gansslen A, Hildebrand F, Kretek C. Transverse + posterior wall fractures of the acetabulum: epidemiology, operative management and long-term results. Acta Chir Orthop Traumatol Cech. 2013;80(1):27-33.

  PMID: 23452418 BACKGROUND

• Giannoudis PV, Tzioupis C, Papathanassopoulos A, Obakponovwe O, Roberts C. Articular step-off and risk of post-traumatic osteoarthritis. Evidence today. Injury. 2010 Oct;41(10):986-95. doi: 10.1016/j.injury.2010.08.003.

  PMID: 20728882 BACKGROUND

• Zhuang Y, Lei JL, Wei X, Lu DG, Zhang K. Surgical treatment of acetabulum top compression fracture with sea gull sign. Orthop Surg. 2015 May;7(2):146-54. doi: 10.1111/os.12175.

  PMID: 26033996 BACKGROUND

• Bertrand R, Derancourt J, Kassab R. Molecular movements in the actomyosin complex: F-actin-promoted internal cross-linking of the 25- and 20-kDa heavy chain fragments of skeletal myosin subfragment. Biochemistry. 1992 Dec 8;31(48):12219-26. doi: 10.1021/bi00163a035.

  PMID: 1457419 BACKGROUND

• Laflamme GY, Hebert-Davies J. Direct reduction technique for superomedial dome impaction in geriatric acetabular fractures. J Orthop Trauma. 2014 Feb;28(2):e39-43. doi: 10.1097/BOT.0b013e318298ef0a.

  PMID: 23681409 BACKGROUND

• Tosounidis TH, Stengel D, Giannoudis PV. Anteromedial dome impaction in acetabular fractures: Issues and controversies. Injury. 2016 Aug;47(8):1605-7. doi: 10.1016/j.injury.2016.07.020. No abstract available.

  PMID: 27499274 BACKGROUND

• Scolaro JA, Routt ML Jr. Reduction of osteoarticular acetabular dome impaction through an independent iliac cortical window. Injury. 2013 Dec;44(12):1959-64. doi: 10.1016/j.injury.2013.07.012. Epub 2013 Aug 2. No abstract available.

  PMID: 23916899 BACKGROUND

• Collinge CA, Lebus GF. Techniques for reduction of the quadrilateral surface and dome impaction when using the anterior intrapelvic (modified Stoppa) approach. J Orthop Trauma. 2015 Feb;29 Suppl 2:S20-4. doi: 10.1097/BOT.0000000000000271.

  PMID: 25486005 BACKGROUND

• Jeffcoat DM, Carroll EA, Huber FG, Goldman AT, Miller AN, Lorich DG, Helfet DL. Operative treatment of acetabular fractures in an older population through a limited ilioinguinal approach. J Orthop Trauma. 2012 May;26(5):284-9. doi: 10.1097/BOT.0b013e31821e10a2.

  PMID: 21926638 BACKGROUND

• Casstevens C, Archdeacon MT, d'Heurle A, Finnan R. Intrapelvic reduction and buttress screw stabilization of dome impaction of the acetabulum: a technical trick. J Orthop Trauma. 2014 Jun;28(6):e133-7. doi: 10.1097/BOT.0000000000000005.

  PMID: 24296594 BACKGROUND

• Lubovsky O, Kreder M, Wright DA, Kiss A, Gallant A, Kreder HJ, Whyne CM. Quantitative measures of damage to subchondral bone are associated with functional outcome following treatment of displaced acetabular fractures. J Orthop Res. 2013 Dec;31(12):1980-5. doi: 10.1002/jor.22458. Epub 2013 Aug 12.

  PMID: 23940014 BACKGROUND

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 11, 2017
• First Posted: May 15, 2017
• Study Start: June 1, 2017
• Primary Completion: June 1, 2021
• Study Completion: June 30, 2022
• Last Updated: July 1, 2022

Record last verified: 2022-06

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)