%0 Journal Article
%T Gunshot Wounds to the Acetabulum
%J Journal of Orthopaedic Trauma
%D 2012
%A Najibi, Soheil
%A Matta, Joel M.
%A Dougherty, Paul J.
%A Tannast, Moritz
%V 26
%N 8
%P 451-459
%X OBJECTIVES: To classify the fracture patterns of gunshot wounds to the acetabulum; identify the associated injuries and complications; determine the predictors of poor outcome and deep infection; and propose a treatment algorithm based on the results. DESIGN: Retrospective review of two trauma registry databases over a 13-year period. SETTING: Multicenter study. PATIENTS: Thirty-nine gunshot wounds to the acetabulum (38 patients). INTERVENTION: Treatment strategy was based on infection control by treating bowel and bladder injury, presence/absence of intra-articular lead, pattern, and stability of the fracture. MAIN OUTCOME MEASUREMENTS: Merle d'Aubigné score, rate of failures, and complications. Multivariate logistic regression analysis to detect predictors of poor outcome and deep infection. RESULTS: There were 32 simple (82%) and seven (18%) associated fracture patterns. Bowel injuries were the most common associated injures. There was a 54% major complication rate. Significant predictors of poor outcome were high-velocity missile, involvement of the acetabular dome, abdominal injury, nerve injury, vascular injury, and male gender. Significant factors associated with deep infection were presence of a bowel injury with primary anastomosis of the bowel and an associated fracture pattern. CONCLUSIONS: The Letournel classification system can be applied to describe these injuries. The successful treatment of the bowel injury directly correlates to infection control. Diverting colostomy is associated with a reduction of the infection rate. Overall, gunshot wounds to the acetabulum are catastrophic injuries with a high complication rate and poor functional outcome. A multidisciplinary algorithm is proposed for treatment of these complex injuries.<p /> <p>Language: en</p>
%G en
%I Lippincott Williams and Wilkins
%@ 0890-5339
%U http://dx.doi.org/10.1097/BOT.0b013e31822c085d