Functional Outcomes of Acetabular Fractures

• Published in: Journal of bone and joint surgery. American volume 2003-10, Vol.85 (10), p.1879-1883
• Main Authors: Moed, Berton R, Yu, Paul H, Gruson, Konrad I
• Format: Article
• Language: English
• Subjects: Acetabulum - injuries; Acetabulum - physiopathology; Acetabulum - surgery; Adolescent; Adult; Aged; Biological and medical sciences; Female; Follow-Up Studies; Fractures, Bone - physiopathology; Fractures, Bone - surgery; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Recovery of Function - physiology; Reproducibility of Results; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-200310000-00002

BackgroundThe Musculoskeletal Function Assessment is a validated, well-designed, self-administered questionnaire that is useful for determining health status. The modified Merle dʼAubigné clinical hip score is the most generally accepted clinical grading system for evaluating the results of acetabular fracture treatment. The purpose of the present study was to evaluate the relationship between the Musculoskeletal Function Assessment and modified Merle dʼAubigné scores in evaluating the results of acetabular fracture treatment.MethodsOne hundred and fifty patients with an acetabular fracture met the criteria for inclusion in the present study, which included a minimum of two years of postoperative follow-up, a complete physical examination with use of the Merle dʼAubigné score, and successful completion of the Musculoskeletal Function Assessment questionnaire. Patients were stratified according to a number of factors, including the type of fracture and whether the fracture was an isolated injury or was part of a multiple-injury complex. The mean duration of follow-up was five years (range, two to seventeen years).ResultsThe mean modified Merle dʼAubigné score was 16.8 (range, 9 to 18), and the mean Musculoskeletal Function Assessment score was 24.9 (range, 0 to 79). The Spearman correlation coefficient between the Merle dʼAubigné score and the Musculoskeletal Function Assessment score was −0.61 (p < 0.0001). Stratification of the patients did not alter these overall results. However, the presence or absence of associated injuries was a significant factor for the Merle dʼAubigné score (p = 0.03). In addition, the Merle dʼAubigné score data were asymmetric, demonstrating a ceiling effect.ConclusionsThe Musculoskeletal Function Assessment scores for these patients were relatively high compared with those for the normal population, indicating that complete return to a preinjury functional level is uncommon despite a good-to-excellent Merle dʼAubigné clinical score. Furthermore, the ceiling effect demonstrated by the Merle dʼAubigné score (despite its high correlation with the Musculoskeletal Function Assessment score) limits its usefulness as a method for evaluating the outcome of treatment of acetabular fractures. There have been few published clinical studies in which the Musculoskeletal Function Assessment score has been used as an outcome measure, and reference values are lacking. The present study provides initial guideline reference values for use in the