Fracture of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury

Author summary

The results of 262 displaced acetabular fractures in 259 patients treated with open reduction and internal fixation (ORIF) within 3 weeks after injury were reviewed after a mean follow-up of 6 years. Anatomical reduction was achieved in 71% (n = 185) of cases. Greater fracture complexity, age > 40 years, and a longer interval between injury and surgical reduction were significantly associated with a decreased rate of anatomical reduction. The overall clinical results were excellent / good for 76% of patients. Significant predictors of a better clinical result were the achievement of an anatomical reduction, postoperative congruence with the acetabular roof, and an excellent or good radiographic result. A worse clinical outcome was associated with damage of the femoral head, age > 40 years, and operative complications. Based on these results, the goal of treatment for these complex fracture types should be an increased rate of anatomical reduction and a decreased rate of operative complications.