Management and Outcomes of Bilateral Acetabular Fractures: A Critical Review of the Literature

Vasileios K Mousafeiris; Anastasia Vasilopoulou; George D Chloros; Michalis Panteli; Peter V Giannoudis

doi:10.1007/s43465-021-00593-1

Management and Outcomes of Bilateral Acetabular Fractures: A Critical Review of the Literature

Indian J Orthop. 2022 Jan 8;56(5):752-761. doi: 10.1007/s43465-021-00593-1. eCollection 2022 May.

Authors

Vasileios K Mousafeiris^{1

2}, Anastasia Vasilopoulou^{1

3}, George D Chloros^{1

4}, Michalis Panteli⁴, Peter V Giannoudis^{4

5}

Affiliations

¹ Orthopedic Surgery Working Group, Society for Junior Doctors, Athens, Greece.
² St. Andrews General Hospital of Patras, Patras, Greece.
³ Korgialeneio Mpenakeio Hellenic Red Cross Hospital, Athens, Greece.
⁴ Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon Wing, Floor D, Great George Street, Leeds, LS1 3EX UK.
⁵ NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK.

Abstract

Background: Bilateral acetabular fractures constitute a rare entity, and their optimal management is unknown.

Materials and methods: A systematic literature search was conducted in PubMed, Embase and Cochrane Library between 1995 and 2020. Inclusion criteria were studies presenting cases of bilateral acetabular fractures and reporting outcomes. Extracted data included patient demographics, injury mechanism, fracture classification, associated injuries, management and outcomes.

Results: Thirty-seven studies (47 cases; 35 males vs 12 females) were included. Mean age was 46 years old (range 13-84) and mean follow-up was 19.8 months (range 1.5-56). High-energy injuries (49%) and seizures (45%) were the most common injury mechanisms. Fracture type distribution differed according to injury mechanism. Treatment was surgical in 70% of cases (75% open reduction and internal fixation vs 25% acute total hip arthroplasty). Outcomes were excellent/good in 58% of patients. Complications included heterotopic ossification (11%), nerve injury (11%), degenerative arthritis (6%), DVT (6%), and infection (3%).

Conclusions: Bilateral acetabular fractures most commonly occur either after trauma or seizures and are commonly managed operatively. They are not devoid of complications, however, more than half (58%) achieve complete functional recovery.

Keywords: Bilateral acetabular fractures; Seizures; Trauma.

Publication types

Review