Author summary
The results of 262 displaced acetabular fractures in 259 patients treated with open reduction and internal fixation (ORIF) within 3 weeks after injury were reviewed after a mean follow-up of 6 years. Anatomical reduction was achieved in 71% (n = 185) of cases. Greater fracture complexity, age > 40 years, and a longer interval between injury and surgical reduction were significantly associated with a decreased rate of anatomical reduction. The overall clinical results were excellent / good for 76% of patients. Significant predictors of a better clinical result were the achievement of an anatomical reduction, postoperative congruence with the acetabular roof, and an excellent or good radiographic result. A worse clinical outcome was associated with damage of the femoral head, age > 40 years, and operative complications. Based on these results, the goal of treatment for these complex fracture types should be an increased rate of anatomical reduction and a decreased rate of operative complications.
