A prospective study of surgically treated acetabular fractures

Between November 1988 and March 1993, 101 patients with 102 fractures of the acetabulum were referred to the authors' institution. They included 31 both column; 25 transverse associated posterior wall; 16 anterior column associated posterior hemitransverse; 9 posterior wall; 7 posterior column associated posterior wall; 7 anterior column; 5 T shaped; and 2 transverse fractures. Thirteen fractures were excluded, leaving 89 patients with 89 operatively treated fractures available for followup. Postoperative radiographs were evaluated for adequacy of reduction and scored on a scale of 1-9 with 9 being perfect. Perfect or near perfect reduction was achieved in 82% of patients. A minimum of 1 year followup was available for 53 patients. Clinical results were assessed in terms of the patients' activities and included their ability to walk, range of motion and pain. Excellent results were achieved in 27 patients and an additional 16 had satisfactory results, for an overall 81% acceptable outcome. Radiographic evidence of posttraumatic osteoarthrosis was present in 40% of patients: mild in 10, moderate in 5, and severe in 5. Heterotopic ossification was Brooker Grade III and Grade IV in 1 patient each. These results indicate that operative treatment of acetabular fractures provides results that are superior to those achieved with nonoperative treatment.