Arthroscopic Reduction and Internal Fixation in Patients with Acetabular Posterior Wall Fractures

• Published in: Clinics in orthopedic surgery Vol. 15; no. 5; pp. 718 - 724
• Main Authors: Hwang, Jung-Mo, Lee, Cheol-Won, Kim, Pil-Sung, Ha, Yong-Chan
• Format: Journal Article
• Language: English
• Published: The Korean Orthopaedic Association 01-10-2023; 대한정형외과학회
• Subjects: Original; 정형외과학
• ISSN: 2005-291X; 2005-4408
• DOI: 10.4055/cios22199

BackgroundThis study aimed to access the radiologic and clinical outcomes after arthroscopic reduction and internal fixation with screws in patients with posterior wall fractures of the acetabulum. MethodsFrom May 2013 to December 2019, 13 patients (11 men and 2 women) with posterior wall fractures of the acetabulum were treated with arthroscopic reduction and internal fixation with screws at two medical centers. The mean age at the index operation was 39 years (range, 22-58 years). The mean duration of follow-up was 23 months (range, 12-46 months). Clinical assessment was performed using the modified Merle d'Aubigné and Postel functional scoring system. The maximum displacement of acetabular or femoral head fragments detected on radiographs was used as radiographic results. Secondary osteoarthritis, osteonecrosis, or heterotrophic ossification was assessed at the latest follow-up. ResultsBony union was shown at 12 weeks of follow-up in all patients. The radiologic outcomes showed an anatomical reduction in 11 patients and a satisfactory reduction in 2 patients. The modified Merle d'Aubigné and Postel functional score was excellent in 7 patients, good in 5 patients, and fair in 1 patient. Two patients had transient pudendal nerve palsy after hip arthroscopy. However, no sciatic nerve palsy occurred. At the latest follow-up, there was no heterotopic ossification, osteonecrosis of the femoral head, or posttraumatic osteoarthritis. ConclusionsArthroscopic reduction and internal fixation with cannulated screws can be good alternative options with good radiographic and clinical outcomes, convenient removal of intra-articular loose body, and low complication rates.