Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns

Objective: To determine radiographic and clinical features that predict rap id failure after open reduction and internal fixation of posterior wall ace tabular fractures. Design: Retrospective radiographic review and patient followup study. Setting: University hospital. Patients: Forty-two patients with posterior wall acetabular fractures. Intervention: Open reduction and internal fixation. Main Outcome Measures: Radiographs, Merle D'Aubigne scores, Musculoskeletal Functional Assessment. Results: Eleven patients had complete loss of joint space by one year posti njury; eight of these individuals required reconstructive surgery. These pa tients more commonly had fractures with comminution of three fragments or m ore (p = 0.001) or fracture into the subchondral are at the level of the ac etabular roof(p = 0.045). Conclusion: Poor outcomes after open reduction and internal fixation are as sociated with certain types of posterior wall fracture patterns.