COMPLICATIONS AFTER POSTERIOR ACETABULAR WALL INTERNAL FIXATION ? AVASCULAR NECROSIS AND NONUNION.

Introduction: Serious orthopaedics injuries caused by high impact trauma due to road traffic accidents are more prevalent in Saudi Arabia. Fractures of posterior wall are the most common type of acetabulum fractures. The outcome after surgical management of acetabular fracture is primarily related to the quality of articular reduction. This management is the most challenging task for surgeons. Methodology: A retrospective cohort study was conducted in a tertiary care hospital, Riyadh, Saudi Arabia. All patients who underwent internal fixation for posterior wall acetabular fracture from October 2013 to September 2015 were included in the study. Post-surgical outpatient evaluation was done clinically by Merle D? Aubigne Y Postel - hip functional evaluation score and radiological assessment using Ficat classification for staging of avascular necrosis of femoral head. Principal results: With increase in age, the function of hip declined. The step in fixation was found significantly associated with avascular necrosis (p = 0.020) and nonunion (p =0.020). The gap was found significantly associated with nonunion only (p= 0.001). Conclusions: Delay in surgery should be avoided if surgical management is decided for posterior acetabular wall fracture. Adequate surgical reduction of fracture of posterior acetabular wall is necessary. Screw seems to be a better choice of implant until further new evidence is received. A randomized controlled trial is needed to evaluate and compare different management options for fracture of posterior acetabular wall and to set standard guidelines for future.