PATTERNS OF ACETABULAR FRACTURES SEEN AT MULAGO AND NSAMBYA HOSPITALS.

Abstract

Background: Fractures involving the acetabulum are life altering injuries with significant morbidity and mortality. Timely diagnosis is important for planning management of these fractures. Despite the availability of a standard classification system in the developed countries, there is a paucity of data on the patterns of acetabular injuries in Africa and particularly in Uganda. This study sought to describe the clinical and radiological patterns of acetabular fractures seen in Mulago and Nsambya hospitals. Methods: This was a descriptive cross-sectional study. We consecutively collected data from 45 patients with acetabular fractures at Mulago and Nsambya Hospitals between November 2018 and March 2019. The patients’ age, sex, trauma mechanism, road user category, affected side, associated injuries, and CT scan based fracture pattern according to the Letournel classification were described. Clinical and radiological patterns of the acetabular fractures were analysed using frequencies and proportions. Chi square and Fischer exact test were used to test the difference in proportions at 5% level of significance. Results: Of the 45 patients included in the study, 78% (n=35) were male; the mean age was 40 years. The most common trauma mechanism was road traffic crash that ocurred 91% (n=41) of the cases. The left side was affected in 67% (n=30) of the cases and over two-thirds of the patients (66.7%, n=30) had associated injuries. Posterior wall fracture was the the most common radiological pattern (27%, n=12), followed by Associated Both Column pattern (22%, n=10). Motorcycle passengers were 14 time more likely to sustain complex patterns compared to motor vehicle passengers(OR=14, 95% CI: 1.5-133). Patients with complex fracture patterns were 8.5 times more likely to have associated osseous injuries compared to patients who suffered simple fracture patterns (OR=8, 95% CI: 1.6-44.5). Conclusion: The typical profile of a patient with an acetabular fracture is of a male in his 30’s and 40’s, who is a victim of a road traffic crash, usually a passengers on a motorcycle, with a posterior wall or Associated Both Column acetabular fracture.