Acetabular fractures in children and adolescents

A retrospective study of 29 acetabular fractures in children 2 to 16 years of age with an average followup of 14 years is presented. Nineteen patients had an additional dislocation of the femoral head and 14 patients had an a ssociated neurologic injury. Surgical treatment was performed in 16 patient s and consisted of open reduction and internal fixation in 14 patients and a simple arthrotomy in two patients. Thirteen patients were treated nonoper atively with traction or bedrest. The outcome was satisfactory in all patie nts with undisplaced fractures and fractures with disruption of a small fra gment. Eight patients with linear fractures with instability all were treat ed surgically. All but one of the patients had a satisfactory functional ou tcome; one patient had early degenerative changes develop after an open pel vic and acetabular fracture. Patients with central fractures and dislocatio ns had a relatively poor outcome, and congruency was achieved in only one o f the four patients who were treated surgically. Results may deteriorate wi th time, as was seen when the results of the current study were compared wi th those published 10 years previously.