Abstract

• The principle of operation for Acetabular fracture is, as for any other intraarticular fracture, required anatomical reduction followed by stable internal fixtion. But it is difficult to make good anatomical recuction with firm fixation, because of complicated anatomy and difficulty with surgical exposure. Traumatic arthitis and avascular necrosis of femoral head could be followed by operation.
  We reviewed 17 cases of complex acetabular fracture treated operatively from January 1984 to December 1991 The prevalent age group was the fourth decade. There were 7 cases of dislocation of the hip, 5 fracture of femur as associated injury. According to the Letournels classification, there were 2 cases of T-shaped fracture, 4 posterior column & posterior wall fracture, 2 anterior column & posterior hemitransverse fracture, 9 both column fracture. Surgical approach was extended iliofemoral method in all cases. The fractuer was fixed internally with only screws in 3 cases and with plate and screws in 14 cases. Treatment results was analyzed by Harriss hip scoring system and Mattas reontgenographic grading system. Among 12 patients who had followed up more than ony year, the satisfactory results were achieved in 76% and the poor results were achieved in 16%. The complications were post traumatic arthritis in 2 cases, avscular necrosis of femoral head 1 cases and skin necrosis 1 case.
  Anatomical reduction and firm fixation is essential for good result and extended iliofemoral approach is one of the good methods for surgical exposure of complex acetabular fracture.

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