Outcomes of acetabular fractures

Acetabular fractures are prognostic relevant fractures in terms of function and daily activities. Open reduction and internal fixation (ORIF) is still the gold-standard in treating these injuries. Over recent years, several reports are dealing with outcome evaluations but have the main disadvantage of combining several fracture types., Thus, it remains unclear to discuss a fracture-based prognosis. This analysis evaluated fracture-type specific results in terms of clinical and radiological outcome. Analyzing elementary fracture types, pure transverse and isolated posterior column fractures are associated with relevant functional impairments. Except for posterior column fractures all other elementary fracture types were associated with degenerative changes in nearly 20%. Anterior column fractures seems to be “forgiving fractures” as they are associated with the longest median time until hip joint failure occurs. In associated fracture-types T-shaped fractures are still demanding fractures with < 60% anatomic reductions and a high rate of functional impairments. All associated fracture types are associated with a relevant rate of secondary degeneration of the hip joint between 20 and 40% of patients. Early hip joint failure (THR, Femoral head necrosis, severe heterotopic ossification) within the 1st year is frequently seen in associated posterior column and posterior wall fractures, but with a relative good prognosis, if the joint survived the first year after ORIF. The highest survival rates of the hip joint is observed with ABC-fractures. Also, these fractures seem to be “forgiving fractures”.