Purpose: The authors would like to report the outcome following evaluation of surgical treatment for acetabular fractures with more than 10 years follow-up.

Materials and methods: 133 consecutive patients were evaluated with 10–16 years post surgery follow-up (mean 12 years). Mean age was 34 years (17 to 70 range) and male: female were 2:1. 90% of our cases were tertiary referrals. The follow-up assessments included AP pelvis and Judet view radiographs and clinical evaluation was performed with the Harris hip score, Modified Merle d’Aubigne score and the SF 36v2 health survey.

Results: Fracture reduction was anatomical in 69% of the patients and in 31% it was non-anatomical. The reduction of the acetabular fractures was considered anatomical when all five lines on post-operative radiographs were corrected and the hip was congruent. Among our patients, 19% had excellent clinical results according to the modified Merle d’Aubigne Score and 58% according to the Harris Hip Score. A poor clinical outcome was identified in 18% of our patients according to the modified Merle d’Aubigne Score and 23% according to the Harris Hip Score. Radiographic evidence of osteoarthritis was in 35,8% of our patients (all grades of arthritis). 6 of our patients had neurological complications (sciatic nerve palsy) (3 pre-operatively, 2 post- operatively and in one patient there was a delayed sciatic nerve palsy secondary to haematoma). In 7 patients (8.6%) there was heterotopic ossification but in only three that was clinically a problem. Two patients developed intraoperatively pulmonary embolism. We had no post-operative deep vein thrombosis or pulmonary embolism.

Conclusions: Our results compare favourably with those of previous published studies with shorter follow-up period. Anatomical fracture reduction is mandatory and improves the clinical outcome. Infection and avascular necrosis are associated with poor clinical outcome. Early surgical intervention for displaced acetabular fractures can improve the final outcome.

Purpose: To assess the long term radiological, clinical and psychological outcome of patients treated surgically for displaced acetabular fractures.

Methods: Over 79 patients were followed up in our outpatient clinic. AP pelvis and Judet view radiographs were taken and evaluated. This was followed by a detailed history and clinical examination. Outcome recorded using the modified Merle d’Aubigne scale. The SF36v2 questionnaire was also administered.

Results: Using the modified Merle d’Aubigne scale:

Excellent 18%, Good 51%, Fair 13% and Poor 18%. Using the SF36v2 health questionnaire (Norm based scoring 1998 US population where 50 is the average score):Transformed physical score (PCS) 44.54 and transformed mental score (MCS) 50.27.

Conclusions: The results represent the learning curve for a single surgeon specifically trained in this speciality. These results compare favourably with those of Matta (JBJS Nov 1996 78A), whose ‘excellent’ & ‘good’ results with a shorter follow up period was 76%. Letournel’s results at 12 years showed a 69% ‘excellent’ & ‘very good’ grade using a slightly different grading system.We have many patients in the ‘good’ grade that have normal walking and range of motion, but miss the ‘excellent’ grade because of slight or intermittent pain. |The results seem to support the surgical treatment of displaced ace-tabular fractures. Most studies show results for short term follow up. Long term follow up studies have implications in predicting the future with regard to medical legal claims.