Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns

Abstract

Objective: To determine radiographic and clinical features that predict rapid failure after open reduction and internal fixation of posterior wall acetabular fractures. Design: Retrospective radiographic review and patient follow-up study. Setting: University hospital. Patients: Forty-two patients with posterior wall acetabular fractures. Intervention: Open reduction and internal fixation. Main Outcome Measures: Radiographs, Merle D'Aubigné scores, Musculoskeletal Functional Assessment. Results: Eleven patients had complete loss of joint space by one year postinjury; eight of these individuals required reconstructive surgery. These patients more commonly had fractures with comminution of three fragments or more (p = 0.001) or fracture into the subchondral arc at the level of the acetabular roof (p = 0.045). Conclusion: Poor outcomes after open reduction and internal fixation are associated with certain types of posterior wall fracture patterns.