Young-Soo Byun; Se-Ang Chang; Young-Ho Cho; Dae-Hee Hwang; Sung-Rak Lee; Sang-Hee Kim

doi:10.12671/jkfs.2007.20.2.123

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Original Article
Surgical Treatment of Posterior Wall Fractures of the Acetabulum: Young-Soo Byun, M.D., Se-Ang Chang, M.D., Young-Ho Cho, M.D., Dae-Hee Hwang, M.D., Sung-Rak Lee, M.D., Sang-Hee Kim, M.D.; Journal of the Korean Fracture Society 2007;20(2):123-128.
DOI: https://doi.org/10.12671/jkfs.2007.20.2.123
Published online: June 14, 2016

Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

Address reprint requests to: Se-Ang Chang, M.D. Department of Orthopedic Surgery, Daegu Fatima Hospital, 576-31 Sinam-dong Dong-gu, Daegu 701-600, Korea. Tel: 82-53-940-7320, Fax: 82-53-954-7417, fatimaos@unitel.co.kr

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results.
Materials and Methods
Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined.
Results
The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications.
Conclusion
In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.
Key words: Acetabulum, Posterior wall fracture, Surgical treatment

REFERENCES

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Fig. 1

Type A1-2 posterior wall fracture by a traffic accident in a 51-year-old man.

(A) Preoperative radiographs and CT scan show displaced fracture fragments of the posterior wall with dislocation of the femoral head.

(B) Postoperative radiographs and CT scan show anatomical reduction of the fracture and fixation with a lag screw, a spring plate and a reconstruction plate, but a small fracture gap due to comminution of the fracture.

(C) Follow-up radiographs 2 years after operation show the normal hip joint without complication. Both clinical and radiographic results are excellent.

Fig. 2

Type A1-2 posterior wall fracture by a traffic accident in a 24-year-old man.

(A) Preoperative radiographs and CT scan show a displaced fracture of the posterior wall with an undisplaced transverse fracture, intra-articular loose body, a fracture of the femoral head, and separation of the symphysis pubis.

(B) Postoperative radiographs and CT scan show anatomical reduction and stable fixation of the posterior wall and femoral head fractures.

(C) Follow-up radiographs 1.5 years after operation show minor spur at the margin of the femoral head and Grade I heterotopic ossification. The clinical result is good.

Table 1

Correlation of the accuracy of the reduction and the clinical results

Table 2

Correlation of the clinical results and the radiographic results

Figure & Data

REFERENCES

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Surgical Treatment of Posterior Wall Fractures of the Acetabulum

J Korean Fract Soc. 2007;20(2):123-128. Published online April 30, 2007

DOI: https://doi.org/10.12671/jkfs.2007.20.2.123

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Surgical Treatment of Posterior Wall Fractures of the Acetabulum

Fig. 1 Type A1-2 posterior wall fracture by a traffic accident in a 51-year-old man. (A) Preoperative radiographs and CT scan show displaced fracture fragments of the posterior wall with dislocation of the femoral head. (B) Postoperative radiographs and CT scan show anatomical reduction of the fracture and fixation with a lag screw, a spring plate and a reconstruction plate, but a small fracture gap due to comminution of the fracture. (C) Follow-up radiographs 2 years after operation show the normal hip joint without complication. Both clinical and radiographic results are excellent.

Fig. 2 Type A1-2 posterior wall fracture by a traffic accident in a 24-year-old man. (A) Preoperative radiographs and CT scan show a displaced fracture of the posterior wall with an undisplaced transverse fracture, intra-articular loose body, a fracture of the femoral head, and separation of the symphysis pubis. (B) Postoperative radiographs and CT scan show anatomical reduction and stable fixation of the posterior wall and femoral head fractures. (C) Follow-up radiographs 1.5 years after operation show minor spur at the margin of the femoral head and Grade I heterotopic ossification. The clinical result is good.

Fig. 1

Fig. 2

Surgical Treatment of Posterior Wall Fractures of the Acetabulum

Table 1

Correlation of the accuracy of the reduction and the clinical results

Table 2

Correlation of the clinical results and the radiographic results

Table 1 Correlation of the accuracy of the reduction and the clinical results

Table 2 Correlation of the clinical results and the radiographic results