OTA 2006 Posters
Scientific Poster #58 Pelvis
Outcomes of Posterior Wall Fractures of the Acetabulum
Berton R. Moed, MD (n); Jessica C. McMichael, MD (n);
St. Louis University School of Medicine, St. Louis, Missouri, USA
Purpose: The Musculoskeletal Function Assessment (MFA) is a validated,
reliable, self-administered questionnaire that is useful for determining
health status. The D'Aubigne score is a clinical measure of hip function.
The purpose of the present study was to evaluate outcomes of posterior wall
acetabular fractures using these two methods.
Methods: 46 patients with a posterior wall acetabular (OTA 62-A1)
fracture and a minimum of 2 years of follow-up, a subset of a previously
reported larger series of all acetabular fracture types, were included for
study. Functional outcome was assessed using the MFA. The MFA score can
range from 0-100; the lower the score, the better. Clinical outcome was
evaluated using the D'Aubigne score, which grades hip pain, hip range of
motion, and gait each on a six-point scale with final grades as follows:
Excellent = 18, Very Good = 17, Good = 16or15, Fair = 14or13, and Poor<13.
The ten individual indices of the MFA and the total scores were calculated.
The mean MFA scores were compared to previously reported normative values.
The t-test for unequal variance was used to compare means with P
<0.05 required for significance.
Results: The mean D'Aubigne score was 17 (range, 14-18), indicating
overall good-to-excellent clinical results in this group of patients. However,
the mean MFA total score was 23.17 as compared to the normative mean of
9.26 (P <0.0005). All MFA indices except Hand/Fine Motor were
similarly significantly different from expected norms at the P <0.05
level (table below).
Musculoskeletal Function Assessment Results
| MFA Category |
PW mean (std. dev.) |
Norm mean* (std. dev.) |
P value |
| Total Score |
23.17 (19.17) |
9.26 (8.89) |
<0.0005 |
| Self-Care |
8.82 (13.64) |
1.72 (4.39) |
<0.003 |
| Sleep/Rest |
29.35 (35.52) |
15.45 (21.88) |
<0.01 |
| Hand/Fine Motor |
5.30 (15.46) |
3.66 (12.90) |
>0.1 |
| Mobility |
30.22 (25.21) |
11.94 (12.73) |
<0.0005 |
| Housework |
26.81 (26.35) |
7.77 (15.38) |
<0.0005 |
| Employment/Work |
35.87 (43.03) |
5.29 (16.71) |
<0.0005 |
| Leisure/Recreation |
43.49 (35.53) |
9.96 (21.88) |
<0.0005 |
| Family Relationships |
19.78 (23.04) |
7.89 (16.61) |
<0.003 |
| Cognition/Thinking |
23.37 (34.32) |
6.10 (17.34) |
<0.003 |
| Emotional Adjustment |
27.29 (22.19) |
15.64 (12.75) |
<0.003 |
*American Academy of Orthopaedic Surgeons Normative Data
Conclusion/Significance: Despite improvement in clinical parameters
after posterior wall acetabular fracture, complete recovery is uncommon
with residual functional deficits involving wide-ranging aspects of everyday
living.
If noted, the author indicates something of value received.
The codes are identified as a-research or institutional support; b-miscellaneous
funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts
disclosed, and *disclosure not available at time of printing.
·
The FDA has not cleared this drug and/or medical device for the use
described in this presentation (i.e., the drug or medical device is being
discussed for an "off label" use). · · FDA
information not available at time of printing.