Association between radiological quality of reduction and functional outcome in posterior wall acetabular fractures treated with ORIF

Shah M. Faisal Eskander; M. Asadullah; M. Masud Rana; Mohammad Osman Gani; Abu Zihad Mohammad Salim; Monir Us Saleheen; Seemran Faisal

doi:10.18203/issn.2455-4510.IntJResOrthop20261200

Authors

Shah M. Faisal Eskander Department of Orthopaedics, Surgery, Enam Medical College Hospital, Savar, Bangladesh
M. Asadullah Department of Orthopaedics, Enam Medical College, Savar, Bangladesh
M. Masud Rana Department of Orthopaedics, Enam Medical College, Savar, Bangladesh
Mohammad Osman Gani Department of Orthopaedics, Enam Medical College, Savar, Bangladesh
Abu Zihad Mohammad Salim Department of Orthopaedics, Enam Medical College, Savar, Bangladesh
Monir Us Saleheen Department of Orthopaedics, Enam Medical College, Savar, Bangladesh
Seemran Faisal Department of Economics and Social Sciences, Brac University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261200

Keywords:

Posterior wall acetabular fracture, ORIF, Radiological outcome, Functional outcome, Hip dislocation

Abstract

Background: Posterior wall acetabular fractures represent the most common subtype of acetabular injuries, frequently caused by road traffic accidents and often associated with hip instability and dislocation. The quality of reduction achieved after open reduction and internal fixation (ORIF) remains a key determinant of prognosis, although other clinical and operative factors may also influence outcomes.

Methods: A prospective observational study was conducted at Dhaka Medical College Hospital from August 2020 to March 2022, including 20 patients (aged 18–60 years) with posterior wall acetabular fractures treated with ORIF. Radiological outcomes were assessed using Matta’s criteria, while functional outcomes were evaluated using the Merle D’Aubigné and Postel score. Associations with demographic, injury-related, and surgical factors were analyzed.

Results: The mean patient age was 38.3 years, with most cases resulting from road traffic accidents (90%). Anatomical reduction was achieved in 80%. Radiological outcomes were excellent in 45%, good in 40%, and fair in 15%. Functional outcomes were excellent in 50%, good in 40%, and fair in 10%. Overall satisfactory outcomes were observed in 90% of patients. Significant predictors of poorer outcomes included hip dislocation (p<0.001), gross displacement (p< 0.001), surgical delay >15 days (p=0.036), and postoperative complications (p=0.001). Demographic factors and fracture extent showed no significant association.

Conclusions: Achieving anatomical reduction is critical for favorable radiological and functional outcomes in posterior wall acetabular fractures. Early surgical intervention and avoidance of complications further optimize long-term prognosis.

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