Late reconstruction of posterior acetabular wall fractures using iliac crest.
BACKGROUND
Reconstructing late posterior acetabular wall fractures is challenging. This study evaluates the use of the iliac crest strut graft for posterior acetabular wall reconstruction.


METHODS
From 1990 to 2004, seven patients (five males and two females) with traumatic posterior acetabular wall defects were reconstructed using autogenous iliac crest strut grafts. The mean age of the patients was 31 years. The mean time from injury to reconstruction was 6.4 months. The clinical (modified Merle d'Aubigné-Postel score) and radiologic evaluation (Matta score) were recorded at the final follow-up.


RESULTS
The mean duration of follow-up was 76 months. On the basis of the modified Merle d'Aubigné-Postel scoring system, the clinical outcomes at final follow-up were as follows: excellent for a pediatric patient; good for three adult patients without posttraumatic osteoarthritis of the hip at the time of reconstruction; and poor for three other adult patients with posttraumatic osteoarthritis of the hip at the time of reconstruction. Radiologic grading at the final follow-up was good in the pediatric patient; fair in three adult patients without posttraumatic osteoarthritis of the hip; and poor in three other patients with posttraumatic osteoarthritis of the hip.


CONCLUSIONS
The reconstruction of the posterior acetabular wall defects using an iliac crest strut graft is a noteworthy technique for late posterior acetabular wall fracture. The technique may be an option for pediatric patients or adults without posttraumatic osteoarthritis of the hip at the time of reconstruction. However, it is not recommended for adult patients with posttraumatic osteoarthritis of the hip. In this case, total hip arthroplasty is a better choice.


METHODS
IV, therapeutic study.
Orthopaedic Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Guo-Chun
GC
Zha
Jun-Ying
JY
Sun
Lian
L
Chen
Hong-Ming
HM
Zheng
Qiang
Q
Wang
Ye
Y
Jin
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult