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

OBJECTIVE: To determine radiographic and clinical features that predict rapid failure after open reduction and internal fixation of posterior wall acetabular fractures. DESIGN: Retrospective radiographic review and patient follow-up 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'Aubigné scores, Musculoskeletal Functional Assessment. RESULTS: Eleven patients had complete loss of joint space by one year postinjury; eight of these individuals required reconstructive surgery. These patients more commonly had fractures with comminution of three fragments or more (p = 0.001) or fracture into the subchondral arc at the level of the acetabular roof (p = 0.045). CONCLUSION: Poor outcomes after open reduction and internal fixation are associated with certain types of posterior wall fracture patterns.

Acetabular fractures classification of Letournel and Judet--a systematic approach.

After a background understanding of the classification of Judet and Letournel and the radiographic anatomy of the pelvis, the majority of acetabular fractures are readily classified by utilizing the steps as outlined above. We feel that a systematic, stepwise approach to classifying acetabular fractures into larger groups and then subclassifying these groups will help simplify the application of the Letournel and Judet classification. Try using this method, and your ability to classify these fractures will improve.