Surgical treatment of displaced fractures of posterior column and posterior wall of the acetabulum

We evaluated the results of open reduction and internal fixation of displaced posterior wall and posterior column fractures of the acetabulum. This was a prospective clinical evaluation of such cases where the main surgical strategy was open reduction and internal fixation with interfragmentary screws and reconstruction plates. Data on 11 patients treated by open reduction (all via Kocher-Langenbech approach)/internal fixation with interfragmentary screws and reconstruction plates were collected. The follow-up period was 61 (18-102) months. Reduction with a fracture gap of less than 2mm without articular stepping was achieved in all 11 cases. Postoperative complications developed in five patients, including subcutaneous haematoma in one, avascular necrosis of the femoral head (AVNFH) in one and heterotopic ossification (HO) in three. All but the patient with AVNFH, had anatomic radiological reduction, and good to excellent functional results. Open reduction and internal fixation with interfragmentary screws and reconstruction plates is the treatment of choice in displaced posterior wall and posterior column fractures of the acetabulum.