title: Associated lesions in posterior wall acetabular fractures: not a valid predictor of failure.
abstract: BACKGROUND
  The general outcome of posterior wall acetabular fractures is still the source of discussion. Posterior wall fractures are recognized throughout the literature as being difficult to treat. The aim of the present study was to analyze in our own patients the relevance of the classical prognostic criteria for the outcome of isolated posterior wall fractures and those with associated lesions.
  
  
  METHODS
  A prospective cohort of 33 consecutive patients treated operatively between 1996 and 2006 in a single level 1 trauma center for a posterior wall fracture of the acetabulum was analyzed retrospectively. Included were posterior wall acetabular fractures or associated posterior wall fractures, such as the combinations of posterior column with posterior wall, transverse with posterior wall, or T-shaped fracture with posterior wall fracture. Outcome measurement of the postoperative survival of the hip joints until the primary outcome reoperation (total hip replacement or fusion) and secondary outcome diagnosis of symptomatic osteoarthritis were performed.
  
  
  RESULTS
  Twenty-six of the 33 patients with posterior wall fractures also had a dislocated joint. Twelve had isolated and 21 associated fractures. Six patients were reoperated with a THA (four patients within 2 years and one after 10 years), and one arthrodesis was done to treat a hematogenous septic arthritis in a degenerative hip joint. Secondary arthritis was observed in 10 patients.
  
  
  CONCLUSIONS
  No difference was found between the outcome in cases of isolated posterior wall acetabular fracture and the outcome in those with associated lesions. The classical prognostic criteria were not found to be relevant to the outcome for our group.
authors.affiliation: Department of Traumatology, University Hospital Basel, 4031, Basel, Switzerland. iselinlukas@mac.com
authors.forename: Lukas Daniel
authors.initials: LD
authors.lastname: Iselin
authors.forename: Peter
authors.initials: P
authors.lastname: Wahl
authors.forename: Patrick
authors.initials: P
authors.lastname: Studer
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Munro
authors.forename: Emanuel
authors.initials: E
authors.lastname: Gautier
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality; D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006617:Hip Dislocation / Q000401:mortality / Q000601:surgery*; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult