Clinical Effect Of The Surgical Treatment Of Fracture Of The Acetabular Posterior Wall

Objective: To investigate the clinical effect of surgical treatment of fracture ofacetabular posterior wall. Methods: From May2004to May2011,35patients withacetabular posterior wal fracture were treated surgically in our hospital.30cases weremale and5were female, Average age of42.4years(16~72years). All cases belong to Aof AO classification, and belong to simple fracture of Letournel classification.Accordingto Letournel classification and X-way,3D, the series consisted of19fractures of typicalposterior wall,6fractures of postero-superior wall and10fractures of postero-inferior wall.There were25cases with hip dislocation and10cases without hip dislocation.30casespatients suffered from traffic accident;3cases were caused by falling from height and2cases suffered from other jnguries. Multiple fractures in11.There were5cases of primarysciatic nerve injury. To observations the time for surgery, postoperative treatment effect,and the incidence of complications. Results: All patients were surgically treatedsuccessfully and fixed with plates and screws. Kocher-Langenbeck approach wasemployed in all cases.35patiens were followed up. The average follow-up was30.0months (7~65months).17cases were accepted transfusion and average3u RBC(2~6u). Allcases were healed in first time without infection and bone nonunion or femoral headosteonecrosis.5cases of primary sciatic nerve injury were in sluggish gait even afteroperation and heterotopic ossification developed in6cases. There was no DVT in all cases.The average interval from injury to surgery was6days(2~14d).The mean operation timewas108minutes (60~170minutes). The amount of bleeding on average372ml (100~1000ml). The mean time of getting after operation were6days (4~8days).The length of inhospital were17.5days (7~36days). The average bone union time were7months(4~13months). According to Matta reduction criteria, modified Merled,Aubingne-Postel scoring system, Anatomical reduction was achieved in28cases; however,3were unsatisfactory and4were poor. For clinical results,21were graded asexcellent,6as good,3as fair and5as poor. Conclusion: Open reduction and internalfixation is a liable method for the fracture of acetabular posterior wall (A). For the cases ofthe hip posteriorly dislocation emergency reduction and tibial draw was an effectivemeans. The reduction quality is closely related to hip function.