Objective: To determine radiographic and clinical features that predict rapid failure after open reduction and internal fixation of posterior wall acetabular fractures.
Design: Retrospective radiographic review and patient follow-up study.
Setting: University hospital.
Patients: Forty-two patients with posterior wall acetabular fractures.
Intervention: Open reduction and internal fixation.
Main Outcome Measures: Radiographs, Merle D'Aubigné scores, Musculoskeletal Functional Assessment.
Results: Eleven patients had complete loss of joint space by one year postinjury; eight of these individuals required reconstructive surgery. These patients more commonly had fractures with comminution of three fragments or more (p = 0.001) or fracture into the subchondral arc at the level of the acetabular roof (p = 0.045).
Conclusion: Poor outcomes after open reduction and internal fixation are associated with certain types of posterior wall fracture patterns.
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