Management of acetabular wall fractures with hip dislocation: A case series

Abstract

Introduction: Posterior wall fractures are the most common type of acetabular fractures. Comminuted fractures with extensions to acetabular roof are associated with poor prognosis. Accurate evaluation of resuting union and likelihood of future arthritis or AVN of femoral head are also hindered. Materials and methods: We report a case series of 9 cases with posterior wall acetabulum fractures associated with posterior dislocation of femoral head treated with internal fixation of posterior wall by three step reonstruction-1)open reduction of dislocation, 2)preservation of soft tissues and reconstruction of marginally impacted and osteochondral fragments using screws, 3)final reinforcement with buttress plating. Functional outcome was evaluated according to D’aubigne and Postel criteria and radiological outcome by criteria of Matta. Results: According to criteria of Matta 44% had excellent, 34% had good and 22% had fair results. According to D’aubigne and Postel criteria 50% had excellent results, 37.5% had good results, 12.5 % had fair results. None of the cases had heterotrophic ossification. Wound site infection eas the only complication encountered. Conclusion: We conclude that this three step rconstruction procedure in management of posterior wall acetabular fracture with posterior dislocation of femoral head results in satisfactory functional and radiological outcome without complications.