Abstract

BACKGROUND:
Isolated posterior wall fractures are common injuries of the acetabulum, anatomical reduction and
stable fixation are the goals of operative treatment when indicated, outcomes of surgical treatment
depend on many patient`s and fracture`s factors.
OBJECTIVE:
To evaluate the functional and radiological outcomes of surgically treated isolated posterior wall
fractures of acetabulum and the effect of patient`s and fracture`s variables on the outcomes in a short
term follow up.
MATERIALS AND METHODS:
Prospective study on twenty patient who met the inclusion criteria treated surgically for isolated
posterior wall fractures of acetabulum at Baghdad Medical City Directorate from July 2014 to
December 2016 with at least one year follow up. All patients were evaluated clinically with
Modified Merle d`Aubigne score and Harris hip score, and radiologically with Matta`s radiological
outcome grading. The effect of gender, BMI, associated dislocation, timing of reduction of
dislocation, timing of surgery, and quality of reduction on the outcomes were evaluated.
RESULTS:
The mean final Modified Merle d`Aubigne score was 15.65 (range, 8 to 18) with excellent and good
results in 16 patient (80%), fair and poor results in 4 patients (20%). The mean final Harris hip score
was 89.2 (range, 65 to 100), with excellent and good results in 16 patient (80%), fair and poor
results in 4 patients (20%).The final radiological outcome results were excellent and good in 17
patient (85%), fair and poor in 3 patients (15%). The functional and radiological outcomes were
significantly affected by the quality of fracture reduction ( p=<0.0001, p=0.0009) respectively. In
addition, the functional outcome was significantly affected by the presence of dislocation (p=0.019),
delay in reduction of dislocation (p=0.0026), and delay in surgery more than 2 weeks (p=<0.0001).
However, gender, and BMI did not show clear effects on the functional outcome ( p=0.938,
p=0.172) respectively.
CONCLUSION:
Satisfactory outcomes can be obtained with open reduction and internal fixation of isolated posterior
wall fractures of acetabulum in short term follow up. Anatomical reduction strictly correlated to both
functional and radiological outcomes with favorable results. Early reduction of hip dislocation
within 12 hours and early surgery within two weeks had favorable functional outcome while the
presence of hip dislocation adversely affects the functional outcome. However differences in gender
and body mass index did not clearly affected the functional outcome.