OPEN REDUCTION AND INTERNAL-FIXATION OF FRACTURES OF THE ACETABULUM -RESULTS IN 163 FRACTURES

Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. This study reports interm ediate term results for a single surgeon of 163 fractures in 161 patie nts treated by open reduction and internal fixation. The mean length o f followup was 3.7 years. The most common fracture patterns treated we re both column (67), transverse/posterior wall (32), posterior wall (1 4), and T shaped (12). The surgical approaches chosen were ilioinguina l (86), Kocher-Langenbeck (58), and extended iliofemoral (26) with 7 p atients having sequential or simultaneous dual approaches. Reductions were rated by plain radiography and considered anatomic in 93 (56%) an d near anatomic (<2 mm displacement) in 40 (25%). There were 7 (4%) in fections, 2 (1%) vascular injuries, 3 (2%) sciatic injuries, and 1 (1% ) obturator nerve injury. Overall outcome was rated as excellent in 23 (14%), good in 101 (61%), fair in 25 (16%), and poor in 14 (9%). Nine patients have undergone hip salvage procedures. These results add to the growing body of clinical data which validates open reduction as th e treatment of choice in most displaced fractures of the acetabulum.