ArticleJournal of clinical orthopaedics and trauma2025
Clinico-radiological outcomes of surgical fixation for posterior column acetabular fractures, with or without posterior wall involvement.
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Posterior column and posterior wall acetabular fractures are associated with hip instability and early development of post traumatic hip arthritis. Literature suggests superior outcomes of isolated posterior column fractures as compared to those involving both posterior column and posterior wall. This study aims to compare functional and radiological outcomes after surgical fixation of posterior column acetabular fractures with or without posterior wall fractures. Methods: A prospective, comparative study was conducted between July 2017 and July 2022. All skeletally mature patients (>18 years old) with acute (<21 days old), elementary/associated posterior column acetabular fracture and managed surgically were included in the study. Based on the involvement of posterior wall, patients were divided into 2 groups: Group A: without posterior wall fractures; and Group B: with posterior wall fractures. Functional outcomes were calculated using Merle D'Aubingne & Postel criteria and radiological outcomes were assessed using Matta's post-op reduction criteria and Matta's radiographic grading at final follow-up. Results: There were 32 patients with acetabular fractures involving posterior column without posterior wall (Group A) and 20 patients with posterior wall involvement (Group B). On comparison, patients in Group A had significantly better functional outcomes at 1 year follow-up (p = 0.01). However, there was no significant difference between Matta's Radiographic reduction criteria immediate post-operatively (p = 0.711) and Matta's Radiographic grade at final 1 year follow-up (p = 0.957). Conclusion: Posterior column acetabular fractures involving the posterior wall have worse functional outcomes and are associated with early failure and post-traumatic arthritis, when treated with fixation of posterior column alone. Future studies should evaluate morphology of posterior wall fragment in the complex fracture patterns, role of its additional surgical fixation and compare it to those with isolated posterior wall fractures.
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