Marginal impaction in complex posterior wall acetabular fractures: role of allograft and mid-term results.

Abstract

To evaluate the functional and radiological outcome of complex posterior wall acetabular fractures with marginal impaction treated with cancellous allograft and internal fixation. A total of 16 patients with marginal impaction on pre-operative CT scan, who underwent internal fixation and allograft were analysed. Mean follow-up was 28months (range 24-42). The mean age was 46.5years (range 22-71). Out of 16 patients, 8 were AO A1.2- and 8 were AO A1.3-type fractures. Functional evaluation was performed using modified Merle d'Aubigné and Postel scores and radiological evaluation by Matta's criteria for quality of initial reduction and final outcome. The quality of reduction was anatomical in 12 patients (75%) and imperfect in 4 patients (25%). The radiological outcome at final follow-up was excellent in 9 (56.25%), good in 5 (31.25%) and fair in 2 patients (12.5%). None of the patients had a secondary loss of reduction at final follow-up. Functional outcome was excellent in 2 (12.5%), good in 8 (50%) and fair in 6 patients (37.5%). The use of cancellous allograft to fill the bone void provides good mechanical stability without any secondary loss of reduction. This surgical technique seems to be effective and safe in treating comminuted posterior wall fractures with marginal impaction without any donor site complications and other disadvantages of synthetic bone graft materials.