We reviewed the records of 222 patients treated for posterior wall acetabular fractures from 1994 to 2006 at our institution. In 71 of these patients a 3.5 mm one-third tubular, small fragment plate was used instead of a reconstruction plate. The patients were followed up for an average of 17 months clinically and with radiographs. All fractures united. There were only two cases of hardware failure; in one a screw broke with no loss of reduction, and in the other the plate broke in a case with an associated posterior column fracture. The one-third tubular plate is quick and easy to apply to the posterior wall. It can be secured, providing a strong tension buttress that maintains reduction. We recommend this plate as the implant of choice for internal fixation of isolated posterior wall acetabular fractures that do not involve the posterior column. If the posterior column is involved a reconstruction plate must be added.
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