Scholarlink

Purpose <p>Durability of anterior-only fixation for posterior column acetabular fractures remains debated, particularly regarding potential loss of reduction over time. This study prospectively evaluated radiographic stability and functional outcomes following fixation performed exclusively through the anterior approach.</p> Methods <p>Between 2019 and 2023, forty-five consecutive patients with displaced acetabular fractures requiring posterior column fixation were enrolled. All underwent reduction and fixation via the anterior approach in the supine position. Patients with old fractures (&gt; 3&#xa0;weeks), pathological fractures, or prior hip surgery were excluded. Standardized radiological assessments measured posterior column height and displacement immediately postoperatively and at 12-month follow-up (mean 15.6 ± 1.2&#xa0;months). Reduction loss was defined as ≥ 2&#xa0;mm displacement. Functional recovery was evaluated using the Harris Hip Score (HHS). Complications were prospectively recorded.</p> Results <p>Mean age was 49.3&#xa0;years. Radiological assessment showed minimal change between immediate postoperative and final follow-up: mean posterior column height increased 0.4&#xa0;mm and posterior displacement 0.7&#xa0;mm. No patient demonstrated displacement ≥ 2 mm. Functional outcomes were excellent, with mean HHS of 92.7 ± 6.4. Subgroup analysis revealed slightly lower scores in cases requiring posterior column fixation with infrapectineal buttressing (mean HHS 89.4 ± 5.1 vs. 94.1 ± 4.2, <i>p</i> &lt; 0.05). One deep infection occurred (2.2% complication rate), managed successfully with debridement. No reoperation for fixation failure or nonunion was required.</p> Conclusion <p>Anterior-only fixation of posterior column acetabular fractures provided durable radiographic stability and excellent short-term functional outcomes at one year, with a low complication rate. While exclusion of irreducible fragments limits generalizability, these findings support the anterior intrapelvic approach as a reliable option in appropriately selected patients. Longer-term follow-up and comparative studies are warranted to determine its role relative to combined or posterior approaches.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Durability of posterior column fixation through the anterior-only approach: a prospective study for assessment of reduction loss

  • 期刊论文

  • 发表日期：

    2026年2月1日

查看全文
  • Mahmoud Fahmy,
  • Mostafa Ahmed Shawky

摘要

Purpose

Durability of anterior-only fixation for posterior column acetabular fractures remains debated, particularly regarding potential loss of reduction over time. This study prospectively evaluated radiographic stability and functional outcomes following fixation performed exclusively through the anterior approach.

Methods

Between 2019 and 2023, forty-five consecutive patients with displaced acetabular fractures requiring posterior column fixation were enrolled. All underwent reduction and fixation via the anterior approach in the supine position. Patients with old fractures (> 3 weeks), pathological fractures, or prior hip surgery were excluded. Standardized radiological assessments measured posterior column height and displacement immediately postoperatively and at 12-month follow-up (mean 15.6 ± 1.2 months). Reduction loss was defined as ≥ 2 mm displacement. Functional recovery was evaluated using the Harris Hip Score (HHS). Complications were prospectively recorded.

Results

Mean age was 49.3 years. Radiological assessment showed minimal change between immediate postoperative and final follow-up: mean posterior column height increased 0.4 mm and posterior displacement 0.7 mm. No patient demonstrated displacement ≥ 2 mm. Functional outcomes were excellent, with mean HHS of 92.7 ± 6.4. Subgroup analysis revealed slightly lower scores in cases requiring posterior column fixation with infrapectineal buttressing (mean HHS 89.4 ± 5.1 vs. 94.1 ± 4.2, p < 0.05). One deep infection occurred (2.2% complication rate), managed successfully with debridement. No reoperation for fixation failure or nonunion was required.

Conclusion

Anterior-only fixation of posterior column acetabular fractures provided durable radiographic stability and excellent short-term functional outcomes at one year, with a low complication rate. While exclusion of irreducible fragments limits generalizability, these findings support the anterior intrapelvic approach as a reliable option in appropriately selected patients. Longer-term follow-up and comparative studies are warranted to determine its role relative to combined or posterior approaches.