Outcomes of operative treatment of acetabular fractures in Brunei Darussalam
Biju BENJAMIN 1, J Fikhri Leong 2, J KYELEVE 3, Dipo OLABUMUYI 2
1 Department of Orthopaedics, Royal College of Medicine Perak, University Kuala Lumpur, Ipoh, Malaysia,2 Department of Orthopaedic Surgery, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam and 3 Sultan Hassanal Bolkiah Institute of Education, University Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam
ABSTRACT
Introduction: Acetabular fractures are severe injuries, and the operative management is a challenge among orthopaedics trauma surgeons. There is no data available on long term follow up results as well as differences between the major acetabular fracture patterns in Brunei. Materials and methods: This is a retrospective study of 42 acetabular fractures treated surgically at RIPAS Hospital, Brunei Darussalam. Clinical and radiological measures were undertaken for measuring outcomes with a mean follow up of four years. Results The 42 cases consisted of 33 men, and 9 women with ages ranging from 13 to 60 years. All fractures were fixed with AO 3.5 mm lag screws, AO spring hook and AO 3.5 mm reconstruction plates through either posterior or ilioinguinal approaches. Congruent reduction was achieved in 41 hips (97.6%). Good or excellent functional results were achieved in 40 patients (95.2%). There was no case of infection. There were two cases of heterotopic ossification and three cases of grade II degenerative changes but none required arthrodesis or total hip replacement. Positive relationship was established between number of days before ambulation and total days spent in the hospital. Though the median duration of hospital stay was 26 days, transverse fractures spent 53.17 days in hospital. Conclusion: Early mobilisation is important to obtain favourable results. Functional results were comparable to other international studies and regional countries. Follow-up of four years is too short to predict the chances of development of degenerative changes in this study and therefore, these cases are still being monitored.
Keywords: Acetabular fracture, operative management, heterotopic ossification, congruency, functional results, Brunei
Correspondence author: Biju BENJAMIN, Department of Orthopaedics, Royal College of Medicine Perak, University Kuala Lumpur, Ipoh, Malaysia
E mail: bijuben@yahoo.com
Brunei Int Med J. 2015; 11 (6): 279-287