Surgical treatment of displaced acetabular fractures: results of 50 consecutive cases.

Results of the surgical treatment of 50 consecutive displaced acetabular fractures were reviewed after a minimum of 2 years and a maximum of 6 years. Twenty-five fractures were complex, and 15 were treated at > or = 3 weeks postinjury. The quality of the reduction was anatomic in 74% of the patients. The rate of osteonecrosis of the femoral head was 10%. Heterotopic bone appeared in 24% of the patients, but function was impaired in only three. Excellent and good results were noted in 76% of the patients. Fractures operated on at > or = 3 weeks (delayed) had a failure rate of 40% compared with 17% for fresh fractures. The failure rate of delayed fractures was negatively influenced by nonoperative treatment initiated before surgery in other centers. Surgical treatment is considered the method of choice for displaced acetabular fractures, provided it is performed by knowledgeable and proficient surgeons.