Surgical treatment of central acetabular fractures

Surgical treatment is indicated in most displaced acetabular fractures in young adults. The fractures are generally intraarticular and almost invariably involve the weight-bearing area of the acetabulum. Complete or near anatomic reduction is essential for an excellent and long-standing recovery of the hip joint, and this is extremely difficult to accomplish by conservative management. Fifty-eight displaced central acetabular fractures treated surgically were followed from one to 12 years. They were evaluated by anteroposterior and oblique roentgenograms and classified according to the Judet-Letournel system. Although surgical treatment was somewhat delayed and the experience in approaching and dealing with these fractures was limited in many of the early cases, excellent or satisfactory reduction to a less than 3-mm displacement at the articular surface was achieved in 81% of cases. A close agreement was found between the quality of surgical reduction and clinical results as well as between roentgenographic and clinical results at the final follow-up examination, which were satisfactory in 72% and 74%, respectively. The surgical complications were infection in 2% of cases, peroneal nerve palsy in 8.5%, and moderate to severe ectopic ossification in 10% of the patients.