Improved outcome after early fixation of acetabular fractures

This study was done in order to evaluate the effect of the timing of fixati on for acetabular and pelvic ring fractures on patient outcome. Demographic , clinical and outcome data for 5821 trauma patients admitted from January 1993 through January 1996 were retrospectively reviewed. Pelvic fractures w ere classified according to Young and Burgess. Patients who had fixation wi thin 24 h of admission were compared with those who had later operation. Ma in outcome measures were Multiple Organ Dysfunction Score according to Moor e, hospital and intensive care unit length of stay and discharge dispositio n. Out of 416 patients with pelvic fractures, one hundred patients had frac ture fixation [90 open reduction and internal fixation, 10 external fixatio n]. There were 59 acetabular fractures and 41 pelvic ring fractures, The ov erall mortality was 4%. Early fixation of acetabular fractures was associat ed with lower MODS (p < 0.006) and decreased total length of stay (p < 0.02 6). Length of hospital stay was also less with early fixation of pelvic rin g fractures (p < 0.04). Functional outcome was improved in early fixation o f acetabular fractures with a greater proportion of patients being discharg ed home rather than to rehabilitation or skilled care (p = 0.05). Patients who underwent early repair of acetabular and pelvic ring fractures had a sh orter length of hospital stay compared to those with late fixation. Patient s with early repair of acetabular fractures had significantly less organ dy sfunction and exhibited improved functional outcome. (C) 2000 Elsevier Scie nce Ltd. All rights reserved.