Computed tomography pattern of Acetabular fractures and associated mechanisms of injuries among patients attending Muhimbili Orthopaedic Institute

Abstract

ABSTRACT Background The acetabulum plays a critical role in weight-bearing and locomotion. Acetabular fractures are increasingly prevalent, often resulting from high-impact traumas such as motor vehicle crashes. Failure to recognize or appropriately treat acetabular fractures can lead to significant long-term consequences, including chronic pain, joint deformity, instability, and the development of post traumatic osteoarthritis. Understanding these patterns could improve diagnostic precision and refine treatment approaches. However, in Tanzania, there is limited knowledge regarding the typical patterns of acetabular fractures and any potential association between mechanisms of injuries and fracture patterns. Objective To determine computed tomography (CT) scan patterns of acetabular fractures and associated mechanisms of injuries among patients attending Muhimbili Orthopaedic Institute (MOI) from June 2023 to March 2024. Material and Methods A prospective cross-sectional study was conducted at the Department of Radiology and Medical Imaging MOI. The study included 81 patients who attended MOI with a diagnosis of traumatic acetabular fracture by X-ray radiography and later on underwent pelvic CT from June 2023 to March 2024. Statistical analysis was conducted using SPSS version 27. Continuous data were summarized with measures of central tendency and dispersion, while categorical data were presented as frequencies and percentages. Cross-tabulations and Fisher's exact tests were employed to assess the associations, with a significance threshold of p < 0.05. Results The study included 81 patients diagnosed with post traumatic acetabular fractures, with a mean age of 41.01 years (± standard deviations of 15.17 years). Notably, the majority affected were male 60 (74.1%), with motor traffic crashes being the leading cause, accounting for 70 (86.4%) of cases. Falls from heights represented 11 (13.6%) of the observed fractures, while no cases of xii acetabular fractures resulting from sports injuries were reported during the study period. Posterior wall fractures were the most common pattern among patients involved in motor traffic crashes, representing 27 (38.6%) of cases. In contrast, anterior wall and anterior column fractures were more prevalent in falls from heights, each constituting 18.2% of cases. However, no significant association was found between CT scan patterns and mechanisms of injuries. Conclusion This study emphasizes the predominance of males as being more affected patients compared to females and motor traffic crashes as the leading cause of acetabular fractures. Posterior wall fracture was the leading pattern among all. There was no association between the CT scan pattern and the mechanism of injury. Recommendation It is recommended to prioritize the review of posterior wall fractures initially, given their prevalent occurrence among patients with acetabular fractures and subsequent attention should be given to other common patterns to hasten the accurate diagnosis. Furthermore, the absence of acetabular fractures resulting from sports injuries or other causes highlights potential areas for further investigation into the factors contributing to these specific injury patterns. Also, males were more affected than females, so it is recommended to put much emphasis on educating this group hence reducing this high percentage. Keywords: Acetabular fractures, Motor traffic accidents, CT scan patterns, Mechanisms of injury.