The Saint-Joseph Acetabular score: a reproducible and accurate prediction of the outcome of open reduction and internal fixation of acetabular fractures.
- Resource Type
- Article
- Authors
- Melhem, Elias; Rizkallah, Maroun; Abid, Hichem; Moreau, Pierre-Emmanuel; Upex, Peter; Zaraa, Mourad; Sadeqi, Mansour; Jouffroy, Pomme; Riouallon, Guillaume
- Source
- International Orthopaedics. Dec2023, Vol. 47 Issue 12, p2977-2984. 8p.
- Subject
- *INTERNAL fixation in fractures
*OPEN reduction internal fixation
*HIP fractures
*DISPLACEMENT (Mechanics)
*INTER-observer reliability
ACETABULUM surgery
- Language
- ISSN
- 0341-2695
Purpose: Acetabular fractures are associated to an increased risk of subsequent hip osteoarthritis. The only available score for post-operative reduction assessment in acetabular fractures (Matta's score) is x-ray based. CT-scan was shown superior to X-rays in post-operative reduction assessment. We aim to describe a CT-scan-based post-operative reduction score in acetabular fractures and evaluate its accuracy and reproducibility. Methods: This is a retrospective study that includes 138 patients who underwent surgery for an acetabular fracture in our tertiary referral centre with a mean follow-up of 104.39±42.2 months. The post-operative CT-scan was reviewed and residual displacement (maximum gap and step) measured by three independent observers. The association between the occurrence of THA and the CT-scan measurements was evaluated. This led to a new prognostic score. The interobserver reliability and accuracy of this score were calculated. Results: Interobserver reproducibility for the residual maximal gap was 0.82 (95% CI [0.70–0.89]) and 0.61 (95% CI [0.52–0.70]) for the residual maximal step displacement measurements. We created a score from a logistic regression model, attributing 1 point for every 1 mm of residual maximal step displacement and 1 point for every 2 mm of residual maximal gap displacement. The interobserver reproducibility of this score was 0.78 (95% CI [0.71–0.84]), and its AUC was 0.79 (95% CI [0.69–0.88]). Conclusion: This is the first CT-scan-based score for the assessment of residual displacement of a surgically treated acetabular fracture. It shows good interobserver reproducibility and accuracy in predicting the risk for secondary THA. It should be regularly used per-operatively (if per-operative 3D imaging is available) and post-operatively to predict the prognosis. [ABSTRACT FROM AUTHOR]