A review of 40 acetabular fractures: the importance of early surgery.

This study demonstrates the importance of early surgery in the management of acetabular fractures. A total of 40 acetabular fractures in 39 patients was treated by open reduction and internal fixation over a 5-year period. Of these, 26 fractures were assessed at over 1 year and up to 4.25 years postoperatively by the Merle D'Aubigné/Postel hip score. Sixteen patients (61.5 per cent) had a good result (16-18), five patients (19.25 per cent) a moderate result (11-15) and five (19.25 per cent) a poor result (0-10). The quality of the clinical result correlated closely with the quality of the reduction of the fracture. The timing of surgery was found to be directly related to the quality of the clinical result. Patients with poor results had been operated on at an average of 17 days after injury, while those with good results had undergone an operation at an average of 11 days. Rapid referral to a regional centre with the necessary facilities and expertise to manage these fractures is recommended in those patients where an operation may be indicated.