Internal fixation of transverse acetabular fractures

It has been shown that fixation of transverse acetabular fractures with a posterior plate and either an anterior column plate or screw provides adequate stability (see T. Sawaguchi et al., Acta Orthop. Scand., vol. 55, p. 601-5, 1984). The hypothesis tested in the current study is that simple transverse acetabular fractures can be fixed by posterior plating alone without the need for anterior column plating or screw fixation. If so, this would reduce operative time and eliminate the difficult task of anterior screw placement or dissection for anterior plating. So the objective of this study was to compare the stability of transverse acetabular fractures fixed with posterior plating alone versus posterior plating and anterior column screw fixation, at both zero and 90° of hip flexion. The authors conclude that: 1. The simple transverse acetabular fractures are “stable” when loaded at 0° of hip flexion and “unstable” when loaded at 90° of hip flexion. 2. There was a statistically significant difference in the axial stiffness and the posterior displacement at the fracture site when comparing no fixation versus fixation only at 90° hip flexion. But there was no significant difference when comparing posterior plating alone versus posterior plate and anterior column screw fixation at both 0° and 90° of hip flexion