ACETABULAR FRACTURES - LONG-TERM FOLLOW-UP OF OPEN REDUCTION AND INTERNAL-FIXATION

Eighty-seven acetabular fractures in eighty-seven patients underwent o pen reduction and internal fixation at Vanderbilt University Hospital from 1984 to 1989. Fifty-six were treated by orthopaedic traumatologis ts. Fifty-six patients returned for long-term follow-up (range 24-80 m onths, average 43). Harris hip ratings were used to clinically grade t he results. Poor results were found in 43%. Eighty-three percent of th e patients with poor results had satisfactory surgical reductions with <3 mm of residual displacement. Factors other than surgical reduction contributed significantly to the poor results. These included hip dis location associated with the fracture, class III or IV heterotopic oss ification, development of avascular necrosis, and age >40 years. These factors in addition to adequacy of surgical reduction allow us to bet ter counsel patients as to long-term prognosis.