Pearls: How to Reduce and Fix Comminuted Posterior Acetabular Wall Fractures

Excerpt

Fractures of the posterior wall of the acetabulum are common, constituting approximately 25% of all acetabular fractures [2]. In addition, their diagnosis is straightforward using standard plain radiographs and CT scans. However, rather than consisting of one uncomplicated fracture fragment, the majority of posterior wall fractures present in combination with intraarticular free fragments and/or fragments of the articular surface that are impacted into the underlying cancellous bone along the margin of the posterior wall fracture line (marginal impaction) [2, 4, 5]. These comminuted intraarticular fractures (Fig. 1A–B) are challenging surgical cases, with many investigators reporting an unsatisfactory outcome in approximately 30% of cases [3, 6].

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