Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture: a study with a minimum follow-up of 15 years.

OBJECTIVES: To evaluate the long-term outcome after surgical management of posterior hip dislocations associated with posterior wall acetabular fracture and to depict prognostic factors that may affect surgical results. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS AND METHODS: Between 1983 and 1991, 19 patients with traumatic posterior hip dislocation associated with posterior wall fracture of the acetabulum were retrospectively reviewed. The clinical criteria proposed by Merle d'Aubigne were used for the evaluation of the patient's clinical status. Matta's radiologic scoring system was used for the analysis of the radiologic data. The Brooker scoring system was used to assess the extent of heterotopic ossification after acetabular fracture surgery. RESULTS: There were 17 male patients and two female. The age range at the time of injury was 16 to 54 years with a mean age of 36 years. Follow-up ranged from 15 to 23 years (mean, 18.5 years). At final follow-up, radiographic outcomes were excellent in six patients (31.58%), good in 11 (57.89%), and fair in two (10.53%) patients. The mean clinical score was 15, ranging from 9 to 18. Clinical outcome was excellent in 10 cases (52.63%), good in six cases (31.58%), and fair in three cases (15.79%). When an anatomic reduction was achieved intraoperatively, excellent or good radiographic and clinical results were shown in 100% and 87.50% of the patients, respectively. CONCLUSION: The adequacy of surgical reduction will determine the long-term outcome of surgically managed posterior hip dislocations associated with posterior wall acetabular fracture. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.