Fractures of the acetabulum.

A critical analysis of the results reveals the following major factors in determining the outcome of an individual acetabular disruption: The damage to the acetabular articular surface, which is reflected by the pattern of fracture and its degree of comminution, impaction, and osteoporosis, and associated damage of the femoral head The adequacy of the reduction, which is reflected by intraoperative inspection and postoperative radiographs The associated complications of the fracture and treatment (e.g., avascular necrosis, sciatic palsy, and heterotopic ossification) We recommend principles of treatment of acetabular fractures comparable to those employed for most other displaced intraarticular fractures, namely an anatomic reduction, stable internal fixation, and early motion, to realize reproducibly optimal results. The principal contraindications to open reduction are osteoporosis and generalized comminution to a degree that precludes a reasonable likelihood for the surgical team to achieve a stable anatomic reduction. We have provided guidelines for the surgical approach, techniques of reduction, and methods of fixation, and an analysis of results, which provide the basis for the successful treatment of these difficult intraarticular injuries.