Non-union of acetabular fractures

Non-unions of acetabulum are rare. Seven cases of acetabular non-unions are reported in this retrospective study. Five out of our seven patients had either transverse or associated transverse with posterior wall fractures. All patients had surgical stabilisation of their index fractures. A diagnosis of non-union was made at an average of 5.8 months from the original injury based on clinical and radiological features. Five of the six patients who underwent re-stabilisation and bone grafting of the non-union healed where as the remaining one did not heal after two attempts at re-stabilisation and was treated with excision arthroplasty. Two of the healed five, subsequently developed osteoarthritis and had total hip arthroplasty where as one patient had already developed degeneration of his hip at the time of diagnosis and hence treated with total hip arthroplasty. Analysis of the non-unions confirmed that fixation was unstable in all with residual displacement seen in two of them. In conclusion acetabular fracture non-union appear to be associated with transverse fractures and unstable fixation.