A PROSPECTIVE-STUDY OF SURGICALLY TREATED ACETABULAR FRACTURES

Between November 1988 and March 1993, 101 patients with 102 fractures of the acetabulum were referred to the authors' institution. They incl uded 31 both column; 25 transverse associated posterior wall; 16 anter ior column associated posterior hemitransverse; 9 posterior wall; 7 po sterior column associated posterior wall; 7 anterior column; 5 T shape d; and 2 transverse fractures. Thirteen fractures were excluded, leavi ng 89 patients with 89 operatively: treated fractures available for fo llowup. Postoperative radiographs were evaluated for adequacy of reduc tion and scored on a scale of 1-9 with 9 being perfect. Perfect or nea r perfect reduction was achieved in 82% of patients. A minimum of 1 ye ar followup was available for 53 patients. Clinical results were asses sed in terms of the patients' activities and included their ability to walk, range of motion and pain. Excellent results were achieved in 27 patients and an additional 16 had satisfactory results, for an overal l 81% acceptable outcome. Radiographic evidence of posttraumatic osteo arthrosis was present in 40% of patients: mild in 10, moderate in 5, a nd severe in 5. Heterotopic ossification was Brooker Grade III and Gra de IV in 1 patient each, These results indicate that operative treatme nt of acetabular fractures provides results that are superior to those achieved with nonoperative treatment.