Fractures of posterior wall of acetabulum

Fy, Chiu; Wh, Lo; Th, Chen; Cm, Chen; Ck, Huang; Hl, Ma

doi:10.1007/bf00439052

Cited by 30 publications

(25 citation statements)

References 11 publications

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“…PAO is also frequently seen after dorsal approaches to the hip [2,18,24]. In our series, 26.1% of the patients developed PAO (Grade 1 to 3), in the series of Chiu et al [5] and Letournel et al [16] 31.2% and 20%, respectively. The extent of the ossifications is related to the extent of traumatic and operative damage to the small and intermediate gluteal muscles and the lateral hip rotators.…”

Section: Discussionmentioning

confidence: 59%

“…Sciatic nerve palsy is a severe complication with only very slow and mostly incomplete recovery. Postoperative sciatic nerve palsy was found in 3.7% of the series of Chiu et al [5] and in 8.3% of our series, which includes the first author's learning curve. Letournel et al [16] described 30 postoperative sciatic nerve damages in 337 (8.9%) Kocher-Langenbeck approaches.…”

Section: Discussionmentioning

confidence: 87%

“…Moreover, 11.6% showed a concomitant neurologic lesion, which definitely compromised functional outcome. In the series of Chiu et al [5], 6.2% also showed femoral head lesions and 12.5% had primary sciatic nerve palsy. The exact number of femoral head fracture in the series of Letournel et al [16] is not known, 27 out of 223 patients (12.1%) suffered sciatic nerve injuries .…”

Section: Discussionmentioning

confidence: 99%

“…In the series of Chiu et al [5], this rate amounted to 81%. In the large series of Letournel et al [16], it was 74%.…”

Section: Discussionmentioning

confidence: 99%

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Is the Posterior Wall Avulsion the Simplest Acetabular Fracture?

2000

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The posterior wall fracture -the most frequent acetabular lesion -is often regarded as the simplest acetabular fracture. In fact, a large variety of complex articular lesions is subsumed under this fracture type.A consecutive series of 60 posterior wall fractures is reviewed retrospectively. Lesion characteristics, treatment method, early and late postoperative complications and 2-year functional results were recorded.In 27 patients (45%), additional damage to the cartilage of the acetabular cavity such as subchondral impaction, free articular fragments or separation of the posterior wall into several pieces was present. Seven patients (11.6%) showed preoperative neurologic deficit. Secondary nerve damage was present in 8.3%. Early secondary surgery was necessary in 8.3%. During the first 2 years, additional surgery was performed in 7/46 patients (15.2%). The rate of periarticular ossifications amounted to 26.1%. The rate of excellent and good results was 69.5%.Posterior wall fracture of the acetabulum is a more complex injury than generally accepted. The trauma surgeon's task is to completely identify the lesion and to consider all aspects of the injury during surgery and rehabilitation. Even in experienced hands, excellent and good long-term results will not exceed 75%. Poor results are due to the difficulty of posterior wall reconstruction, partial osteonecrosis and/or complications caused by the Kocher-Langenbeck approach.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…In the series of Chiu et al [5], this rate amounted to 81%. In the large series of Letournel et al [16], it was 74%.…”

Section: Discussionmentioning

confidence: 99%

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Is the Posterior Wall Avulsion the Simplest Acetabular Fracture?

2000

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“…Frakturen der hinteren Wand sind in 78,8% (68-95%) mit einer traumatischen Hüftluxation vergesellschaftet [2,4,13,19,28,34]. Begleitende primäre Läsionen des Nervus ischiadicus sind in 14,3% (6,7-14%) zu erwarten [1,2,4,15,19,23,26,28,34].…”

Section: Internal Fixation Of Acetabular Posterior Wall Fracturesunclassified

Osteosynthese von Frakturen der hinteren Wand des Azetabulums

2009

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Between January 1, 1972 and December 31, 2005, 137 patients with fractures of the posterior wall of the acetabulum were treated operatively. A high-velocity trauma was the cause of injury in 91.1% of cases. 94.1% of these patients had an additional hip dislocation, which was reduced within 6 h post injury in 83.7%. A primary sciatic nerve injury was present in 22.2%. Additional injuries to the acetabular cartilage were found in 43%, additional femoral head lesions in 27.4%, and Pipkin fractures in 14.1%. Anatomic joint reconstruction (0-1 mm) was observed in 96.3%, the other five patients had near anatomic reconstructions (2-5 mm). All hip joints were congruent on conventional radiography. The overall complication rate was 11.8%. Osteosynthesis-related complications were seen in 6.7%. 86 patients had follow-up results after a mean of 52 months. A perfect or good functional result (Merle d'Aubigné Score) was observed in 73.3% of cases, a posttraumatic arthrosis of the hip joint was present in 31.4%.

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Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures

Ebraheim

Patil

Liu

et al. 2006

International Orthopaedics (SICO

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Fractures of the posterior wall are the most common of the acetabular fractures. The aim of this study was to assess the medium-term results of reconstruction of comminuted posterior wall fractures of the acetabulum by using the buttress technique. This is a retrospective review conducted at a level 1 trauma centre. Thirty-two patients (25 men, 7 women, mean age 41 years, range 14-80 years) with comminuted posterior wall fracture of the acetabulum underwent reconstruction of the posterior wall during the period of July 1998 to February 2004. The average follow-up was 43 months (range 24-70 months). Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Radiographic evaluation was according to criteria developed by Matta. The postoperative reduction was graded as anatomical in 28 patients (88%) and imperfect in 4 patients (12%). The clinical outcome was excellent in 11 (34% ), very good in 9 (28%), good in 4 (12%), fair in 3 (9%) and poor in 5 (15%). Radiological grading at the final follow-up was excellent 12 (37%), good 11 (34%), fair 4 (12%) and poor 5 (15%). Reconstruction of comminuted posterior wall acetabular fractures by buttress technique can be expected to produce good results. It can provide a stable fixation of the posterior wall amenable to early range of motion and weight bearing.

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Fractures of posterior wall of acetabulum

Cited by 30 publications

References 11 publications

Is the Posterior Wall Avulsion the Simplest Acetabular Fracture?

Is the Posterior Wall Avulsion the Simplest Acetabular Fracture?

Osteosynthese von Frakturen der hinteren Wand des Azetabulums

Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures

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