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Updated: Jan 31, 2026

Fracture Apparatus Design and Protocol Optimization for Closed-stabilized Fractures in Rodents
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Cortical Impaction in Posterior Wall Acetabular Fractures.

Jonathan G Eastman1, Jacob H Fennessy1, Bradley Deafenbaugh2

  • 1Department of Orthopaedic Surgery, Davis Medical Center, University of California, Sacramento, CA.

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Extra-articular posterosuperior acetabular cortical impaction is an uncommon finding in posterior wall acetabular fracture-dislocations. Careful review of preoperative imaging is crucial for surgical planning and achieving anatomical reduction.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Radiology

Background:

  • Posterior wall acetabular fractures are often associated with dislocations.
  • Acetabular impaction injuries can complicate fracture reduction and outcomes.

Purpose of the Study:

  • To determine the incidence of extra-articular posterosuperior acetabular cortical impaction in posterior wall acetabular fracture-dislocations.
  • To evaluate the impact of this impaction on reduction accuracy.

Main Methods:

  • Retrospective case series of 97 patients with isolated posterior wall acetabular fracture-dislocations.
  • Review of preoperative and postoperative CT scans, including 3D reconstructions.
  • Assessment of radiologist reports for noted cortical impaction.

Main Results:

  • Four of 99 patients (4.12%) exhibited cortical impaction on preoperative CT.
  • Reduction accuracy varied, with 1 anatomical, 2 imperfect, and 1 poor reduction among those with impaction.
  • Cortical impaction was not mentioned in final attending radiologist reports.

Conclusions:

  • Cortical impaction of the posterosuperior acetabular surface is an uncommon but identifiable entity in posterior wall acetabular fractures.
  • Scrutinizing preoperative imaging is essential to detect this condition.
  • Identifying impaction aids in surgical planning for optimal reduction and potential approach modifications.