Clinical and Radiological Outcomes of Unstable Posterior Acetabular Wall Fractures with Associated Hip Dislocation Treated by Open Reduction and Internal Fixation: A Prospective Study

Background: Unstable posterior acetabular wall fractures associated with hip dislocation are severe injuries resulting from high-energy trauma and are associated with significant morbidity if not managed appropriately. This study evaluate the clinical and radiological outcomes of unstable posterior acetabular wall fractures with hip dislocation following surgical management and to assess the correlation between functional and radiological outcomes. Material and Methods: This prospective observational study included 15 patients with unstable posterior acetabular wall fractures and hip dislocation treated with open reduction and internal fixation. Clinical outcomes were assessed using the Harris Hip Score and Merle d’Aubigné and Postel score, while radiological outcomes were evaluated using Matta’s criteria over a minimum 12-month follow-up. Statistical analysis was performed using paired t-test and Chi-square test, with p<0.05 considered significant. Results: The majority of patients were males (80.0%) aged 31–40 years (40.0%), and road traffic accidents were the predominant mechanism of injury (73.3%). At final follow-up, 73.3% of patients achieved excellent-to-good functional outcomes, while 80.0% demonstrated excellent-to-good radiological outcomes. Mean functional scores improved significantly from 6.2 ± 1.1 preoperatively to 15.6 ± 1.4 at 12 months. A significant association was observed between radiological and functional outcomes (χ² = 9.545, p = 0.023). Heterotopic ossification and avascular necrosis were the most common complications, occurring in 13.3% of patients each, resulted in a slight decline in long-term outcomes. Conclusion: Early anatomical reduction and surgical fixation provide favorable clinical and radiological outcomes in unstable posterior acetabular wall fractures with hip dislocation. Radiological outcome is a significant predictor of functional recovery.

Keywords: Harris Hip Score, Hip dislocation, Posterior acetabular wall fracture, Open reduction and internal fixation, Radiological outcome.