Displaced acetabular fractures occur primarily in adults involved in high energy trauma and can lead to disabling post traumatic arthritis and joint instability. The principle of management for this fracture is as for any other displaced intra
articular
fracture, anatomical reduction is essential for good long term function, more often, open reduction followed by stable internal fixation allowing early active or passive motion is required.
Matta et al(1986) reported that displaced fracture must be reduced to a displacement of 3mm or less, in addition to congruent reduction of the femoral head with weight bearing dome of the acetabulum to achive a satisfactory clinical result.
The clinical observation was performed on 16 patients among the 23 displaced acetabular fracture patients who underwent operative intervention. All 16 cases had displacement of minimum 5mm and involved at least one entire column, who had been
admitted
and operated at S.C.H. University Hospital from January 1986 to June 1990.
@ES The results obtained were as follows.
@EN 1. According to Letournel's classification, 5 cases were elementary fracture and 11 cases were associated fracture.
2. Surical approaches were Kocher-Langenbeck in 6 cases, Posterior transtrochanteric in 4 cases, Ilioinguinal in 2 cases, Triradiate transtrochanteric in 4 cases.
3. The satisfactory result was achieved in 11 cases(68.8%) on clinical grade and 12 cases(75%) on radiographic grade.
4. The complications were developed in 6 cases(37.5%) out of 16 cases, such as post-traumatic arthritis in 2 cases, post-traumatic arthritis and ectopic arthritis and ectopic ossification in 1 case, necrosis of femoral head due to penetrating
injury in
1 case and transient sciatic nerve palsy in 2 cases.
5. The clinical result and prognosis was influenced by fracture type and reduction. Reduction of acetabular fracture by surgery to an anatomic or minimally displaced position was the factor correlated most closely with a satisfactory result.
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