Conservative treatment of acetabular fractures: the role of the weight-bearing dome and anatomic reduction in the ultimate results.

A retrospective study of 57 conservatively treated acetabular fractures with an average followup of 7.9 years is presented. The overall functional result was satisfactory in 75%. The least satisfactory results were seen in fractures crossing the weight-bearing dome of the acetabulum in which congruency could not be achieved (N = 11, nine patients had fair or poor results). However, fractures crossing the weight-bearing dome which could be reduced by traction to less than 2 mm (N = 8) gave good or excellent results in seven patients. It is concluded that conservative treatment of acetabular fractures can be very successful, even in fractures crossing the weight-bearing dome, provided that congruence is preserved during the period of traction.