Complex Fractures of the Posterior Wall of the Acetabulum: Current Concept in the Management and Results of the Italian Survey

BACKGROUND: Fractures of the posterior wall of the acetabulum are burdened by several unresolved issues. AO trauma Italy investigated the trend in the management of the most common acetabular fracture among orthopedic surgeons in Italy. A literature-based survey investigating the habits in conservative management, diagnosis, initial treatment, surgical approaches, fixation methods and postoperative management has been released. METHODS: Fifty-five surgeons of varying experience answered questions and discussed the results in an online webinar. Agreement was found about most of the topics; standard AP pelvic X-ray followed by the oblique views and CT scan are required by the most before surgery. RESULTS: The more reliable method of testing hip stability is dynamic stress under fluoroscopy in general anesthesia. In case of associated hip dislocation, the reduction maneuver should be attempted rapidly after ruling out any associated lesions. The Urgent Management protocol was proposed. There was more disagreement about primary hip replacement as a treatment option and the postoperative protocol, both of which were said to be patient-specific. CONCLUSIONS: The results of the survey reflected the trend in the current literature.