Surgical treatment of posterior fracture-dislocation of the acetabulum: Five-year follow-up

摘要

Background/Purpose: Acetabular fractures are a relatively uncommon fracture type. Among patients with acetabular fractures, posterior wall fractures are the most common. Open reduction and internal fixation is the treatment of choice for this type of injury. Anatomical reduction with rigid fixation as early as possible is the immediate goal of surgical treatment. This study retrospectively evaluated the clinical outcomes and radiographic findings of our clinical practices. Materials and methods: This study analyzed the short-term clinical results of 16 cases of acetabular posterior fracture-dislocations with 2 to 6 years of postoperative follow-up. The first study group included 13 patients who underwent open reduction and internal fixation with plates and screws. The second study group included 3 patients who underwent open reduction and internal fixation with screws only. Results: The second group who underwent fixation with small AO screws alone failed to provide enough rigidity and led to premature failure in three cases. Otherwise, there was only one case of implant failure in fixation with plates and screws, because of nonunion of the fracture site 8 months after surgery. Conclusions: We recommend using buttress plates with screws for the fixation of the fractures in this relatively uncommon injury, especially in younger patients. Total hip arthroplasty, using femoral head autografting to augment acetabular deficiency, is a reliable salvage procedure for failed open reduction and internal fixation of acetabular posterior fracture-dislocations.