Clinical Failure After Posterior Wall Acetabular Fractures: The Influence of Initial Fracture Patterns

To determine radiographic and clinical features that predict rapid failure after open reduction and internal fixation of posterior wall acetabular fractures.Retrospective radiographic review and patient follow-up study.University hospital.Forty-two patients with posterior wall acetabular fractures.Open reduction and internal fixation.Radiographs, Merle D'Aubigné scores, Musculoskeletal Functional Assessment.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).Poor outcomes after open reduction and internal fixation are associated with certain types of posterior wall fracture patterns.