title: Reconstruction of acetabular posterior wall fractures.
abstract: BACKGROUND
  The results after acetabular fracture are primarily related to the quality of the articular reduction. We evaluated the results of internal fixation of posterior wall fractures with using three-step reconstruction.
  
  
  METHODS
  Thirty-three patients (mean age at the time of injury, 47.9 years; 28 males and 5 females) were followed for a minimum of 2 years after surgery. The three-step reconstruction included 1) preservation of soft tissues and reduction of the marginally impacted osteochondral (articular) fragments using screws, 2) filling the impacted cancellous void with a bone graft, and 3) reinforcement with buttress-plating. Clinical evaluation was done according to the criteria of D'aubigne and Postel, while the radiological criteria were those of Matta. The associated injuries and complications were evaluated.
  
  
  RESULTS
  The clinical results were excellent in 15 (45.5%) patients and they were good in 5 (15.2%), (i.e., satisfactory in 60.7%), while the radiologic results were excellent in 10 (30.3%) and good in 14 (42.4%) (satisfactory in 72.7%). Heterotopic ossification was common, but this did not require excision, even without prophylactic treatment with indomethacin. Deep infection was the worst complication and this was accompanied by a poor outcome.
  
  
  CONCLUSIONS
  This study confirms that three-step reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum. Therefore, we anticipate less long-term arthrosis in the patients treated this way.
authors.affiliation: Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea. kimht@pusan.ac.kr
authors.forename: Hui Taek
authors.initials: HT
authors.lastname: Kim
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Ahn
authors.forename: Jun-Oh
authors.initials: JO
authors.lastname: Hur
authors.forename: Jong-Seo
authors.initials: JS
authors.lastname: Lee
authors.forename: Sang-Jin
authors.initials: SJ
authors.lastname: Cheon
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic; D011859:Radiography; D013530:Surgical Wound Infection; D016896:Treatment Outcome; D055815:Young Adult