Purpose: Appropriate treatment of fractures of the acetabulum is well known but there is a risk of subsequent degeneration. Few reports of series reviewed after ten years are available. We report a series of 136 treated fractures of the acetabulum with a mean follow-up of 16 years.

Material and methods: Between 1972 and 1996, a total of 554 fractures of the acetabulum were treated. An independent operator reviewed 136 cases. The Judet Letournel classification was applied. Reduction was studied on the AP and 3/4 oblique views of the pelvis using the SOFCOT (November 1981) criteria. Intra- and postoperative parameters (blood loss, complications) were noted. Functional outcome was assessed with the Postel-Merle-d’Aubigné score.

Results: Orthopaedic treatment was used for 38% of the fractures. Forty-one percent were non-displaced and 54% were minimally displaced; 5% of patients had a contraindication for surgery. Reduction was achieved in 28% of the displaced fractures. Among the patients treated orthopaedically, 71% had a good or very good outcome. Anatomic reduction was achieved in 80%. The main complications were sciatic nerve injury (14%), heterotopic ossifications (18%), infection (5%) and intraarticular screws (5%). Good or very good outcome was achieved in 69%. A total hip arthroplasty was implanted in 19% at mean 8 years. Factors significantly related with poor outcome (p< 0.05) were age, posterior displacement, and surgeon experience. There was a good correlation between the function score and radiological signs of osteoarthritis.

Discussion: This is the longest follow-up reported in the literature. For operated patients, the percentage of good and very good outcomes was lower than in other series despite a good rate of anatomic reduction which thus is not a guarantee of good long-term outcome. Other prognostic factors found in the literature include fracture of the femoral head, type of fracture, and quality of the reduction. Long term follow-up remains essential for pertinent analysis of joint surgery.

Purpose: We report our experience with costal osteochondral autografts of the scaphoid for the treatment of radioscaphoid osteoarthritis complicating chronic scapholunate non-union or dissociation.

Material and methods: The technique was used for nine patients from 1994 to 2001 (eight men and one woman, mean age 45 years, age range 26–62). The proximal two-thirds of the scaphoid were resected. An osteocartilaginous graft was harvested from the ninth rib and after remodelling to the scaphoid cavity was fixed to the base of the scaphoid with a Kirshner wire.

Results: Mean follow-up was 2.5 years. Pain improved significantly in all patients. Force was 80% on average compared with the healthy side. Mean wrist motion in flexion and extension was 91° (70–150°).

Conclusion: This technique has provided encouraging preliminary results in terms of restored force and wrist motion. It is an interesting alternative to conventional techniques.