• OBJECTIVE
    • This study reports the complications and functional outcomes in patients treated acutely with combined open reduction internal fixation (ORIF) and immediate total hip arthroplasty (THA) for displaced comminuted acetabular fractures.
  • DESIGN
    • Single surgeon retrospective case series.
  • SETTING
    • Level 1 trauma center.
  • PATIENTS
    • Thirty-three consecutive patients (18 women; mean age, 66 years) from 1996 to 2011 with an average follow-up of 5.6 years (range, 1-14.3 years) were included in this study.
  • INTERVENTION
    • ORIF and immediate THA.
  • MAIN OUTCOME MEASUREMENTS
    • Oxford Hip Score and reoperation.
  • METHODS
    • All patients had at least 1 year of telephone or clinical follow-up. Postoperative complications, reoperations, and available radiographs were reviewed.
  • RESULTS
    • Six patients died of causes unrelated to their injuries or surgery; before death, these patients had well-functioning hips. There was a 15% complication rate. At last follow-up, 94% of hips remained in situ and were functioning well. The average Oxford Hip Score at final follow-up was 17 (range, 12-32), with 93% of patients reporting good to excellent function. There was no statistical association between fracture type, age, or fixation type and outcome.
  • CONCLUSIONS
    • Acute ORIF and immediate THA for selected acetabular fractures is a safe viable treatment option with good to excellent functional outcomes and may reduce the need for 2 separate operations in many patients. Functional outcomes are equivalent to those after primary THA for osteoarthritis. This study does not address at which age acute THA is a cost-effective treatment option.
  • LEVEL OF EVIDENCE
    • Therapeutic level IV. See Instructions for authors for a complete description of levels of evidence.