Aim: To set decisive factors for final outcome of acetabular fractures (AF) in disrupted pelvic ring (DPR).

Setting: Level I TC.

Method: Retrospective case analysis study.

Material: Jan 1990–Jan 2000, 19 AF with DPR at 19 adult patients (P) were treated. There were 15 AO type B and 4 type C DPR, 5 type A, 7 type B and 7 type C AF. ISS mean 22 (34–9). Emergency stabilisation was performed by external fixation at 11 P and by skeletal traction at 8 P. 16 P (all skeletal traction) underwent ORIF mean 9 days from injury, 4 were reoperated. General complications occured at 5 and local at 8 P, 1 P deceased. 17 P were evaluated (Burks score) mean 4,1 y. after injury.

Results: The Burks score ranged 98,5–37,4 points with 12 excellent-good (EGR) vs. 5 fair-poor results (FPR). We found no significant differences in sex, ISS, AO type of DPR, type of emergency stabilisation, time to ORIF and general complications between the groups of EGR and FPR. There were significant differences in: mean age 33,1 y. in EGR vs. 43,1 y. in FPR; 33% C type AF in EGR vs. 60% in FPR; 8,3% instability rate after ORIF of AF in EGR vs. 80% in FPR; 25% local complications rate in EGR vs. 80% in FPR; no femoral head necrosis in EGR vs. 60% in FPR; mean 3,5 y. from injury to evaluation in EGR vs. 5,7 y. in FPR.

Conclusion: The decisive factors are: age of patient, pattern of acetabular fracture, local complications and femoral head necrosis occurence, time from injury to evaluation. Quality of acetabular reconstruction by ORIF is crucial.