Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers
Abstract Background The treatment of acetabular fractures ranges from non-operative with no restrictions in mobilisation to some of the more complex operative treatments in orthopaedics. Treatment strategies are developing, and outcomes need to be studied continuously. The study’s primary aim was to...
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BMC
2025-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05796-y |
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| author | Madelene Albrektsson Michael Möller Mikael Sundfeldt David Wennergren Olof Wolf |
| author_facet | Madelene Albrektsson Michael Möller Mikael Sundfeldt David Wennergren Olof Wolf |
| author_sort | Madelene Albrektsson |
| collection | DOAJ |
| description | Abstract Background The treatment of acetabular fractures ranges from non-operative with no restrictions in mobilisation to some of the more complex operative treatments in orthopaedics. Treatment strategies are developing, and outcomes need to be studied continuously. The study’s primary aim was to assess the rate of secondary treatment in patients with acetabular fractures treated non-operatively or operatively. A secondary aim was to study mortality. Methods Data were retrieved from the Swedish Fracture Register and cross-referenced with the Swedish Arthroplasty Register for all patients aged ≥ 18 years with an acetabular fracture between 2014 and 2023. Patients were divided into three primary treatment groups: non-operative treatment, open reduction and internal fixation (ORIF), and total hip arthroplasty (THA) with/without combined ORIF (THA/combined hip procedure, CHP). The study examined mortality rates within each treatment group. Results Of the 3318 patients included in the study, 74% were treated non-operatively, 18% with ORIF, and 8% with THA/CHP. 4% of non-operatively treated patients and 17% of patients treated with ORIF had been converted to THA at 5 years, 12% of patients with THA as primary treatment had been revised. Patients who underwent THA as their initial treatment were more likely to undergo secondary treatment early. However, in those initially treated with ORIF the prevalence of secondary treatment increased after the first year. The non-operatively treated group had the highest mortality rate (19% at 1 year), followed by the THA group (14% at 1 year). Conclusions This observational nationwide register study on acetabular fractures shows that surgically treated patients have a relatively high reoperation rate. Younger patients are predominately treated with ORIF and display low mortality rates. Older patients with complex fracture patterns may benefit from primary treatment with THA/CHP being more frequently performed compared to prevailing practice. |
| format | Article |
| id | doaj-art-bcf66103e5914bf6b9df700c981ce0e6 |
| institution | OA Journals |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-bcf66103e5914bf6b9df700c981ce0e62025-08-20T01:51:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-05-012011910.1186/s13018-025-05796-ySecondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registersMadelene Albrektsson0Michael Möller1Mikael Sundfeldt2David Wennergren3Olof Wolf4Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Surgical Sciences, Uppsala UniversityAbstract Background The treatment of acetabular fractures ranges from non-operative with no restrictions in mobilisation to some of the more complex operative treatments in orthopaedics. Treatment strategies are developing, and outcomes need to be studied continuously. The study’s primary aim was to assess the rate of secondary treatment in patients with acetabular fractures treated non-operatively or operatively. A secondary aim was to study mortality. Methods Data were retrieved from the Swedish Fracture Register and cross-referenced with the Swedish Arthroplasty Register for all patients aged ≥ 18 years with an acetabular fracture between 2014 and 2023. Patients were divided into three primary treatment groups: non-operative treatment, open reduction and internal fixation (ORIF), and total hip arthroplasty (THA) with/without combined ORIF (THA/combined hip procedure, CHP). The study examined mortality rates within each treatment group. Results Of the 3318 patients included in the study, 74% were treated non-operatively, 18% with ORIF, and 8% with THA/CHP. 4% of non-operatively treated patients and 17% of patients treated with ORIF had been converted to THA at 5 years, 12% of patients with THA as primary treatment had been revised. Patients who underwent THA as their initial treatment were more likely to undergo secondary treatment early. However, in those initially treated with ORIF the prevalence of secondary treatment increased after the first year. The non-operatively treated group had the highest mortality rate (19% at 1 year), followed by the THA group (14% at 1 year). Conclusions This observational nationwide register study on acetabular fractures shows that surgically treated patients have a relatively high reoperation rate. Younger patients are predominately treated with ORIF and display low mortality rates. Older patients with complex fracture patterns may benefit from primary treatment with THA/CHP being more frequently performed compared to prevailing practice.https://doi.org/10.1186/s13018-025-05796-yAcetabular fracturesSecondary treatmentReoperationsRevision surgeryTotal hip arthroplastyMortality |
| spellingShingle | Madelene Albrektsson Michael Möller Mikael Sundfeldt David Wennergren Olof Wolf Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers Journal of Orthopaedic Surgery and Research Acetabular fractures Secondary treatment Reoperations Revision surgery Total hip arthroplasty Mortality |
| title | Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers |
| title_full | Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers |
| title_fullStr | Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers |
| title_full_unstemmed | Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers |
| title_short | Secondary surgery and mortality following primary treatment for acetabular fractures – an observational study from Swedish national quality registers |
| title_sort | secondary surgery and mortality following primary treatment for acetabular fractures an observational study from swedish national quality registers |
| topic | Acetabular fractures Secondary treatment Reoperations Revision surgery Total hip arthroplasty Mortality |
| url | https://doi.org/10.1186/s13018-025-05796-y |
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