Analysis of Operative Treatment for Complex Acetabular Fractures Involving the Posterior Wall

Abstract：Objective To evaluate the results of patients with operatively treated complex acetabular fractures involving the posterior wall retrospectively. Methods We reviewed fifty-nine patients who undurent open reduction and internal fixation of an unilateral fracture of the acetabulum between August 2003 to August 2013. Forty-one patients were diagnosed as trans-verse plus posterior wall fracture and eighteen patients were diagnosed as posterior column plus posterior wall fracture. The functional outcome was evaluated using a modification of the clinical grading system developed by Merled′Aubigné and Postel. The radiographs were graded according to the criteria described by Matta. Results Fifty-nine patients were followed for a mean of 4. 3 years(range,2. 0~8. 8 years). The radiographic result was excellent in twenty-three patients(39%),good in twenty-two(37%),fair in ten(17%),and poor in four(7%). The clinical outcome at the time of final follow-up was graded as excellent in twenty-one patients(36%),good in twenty-six(44%),fair in nine(15%),and poor in three(5%). Con-clusion Anatomic reduction and stable internal fixation is the key in obtaining satisfactory results in the management of these fractures. According to our result,we recommend to fix these fractures using double plates.