Aim: The purpose of this study is to determine the outcome in patients with acetabular fractures treated either conservatively or surgically

Method: From 1990–2000, we treated 152 patients with 158 acetabular fractures. 63 patients were treated nonoperatively and 95 operatively. According to Tile classification there were 70 type A, 52 type B, 36 type C fractures. Mean follow up was 90 months (23–151 months). Indications for surgery were fracture displacement of more than 2mm, hip joint instability, intrarticular fragments and ipsilateral femoral fracture. Surgical approaches used included the kocher-Langenbeck and the triradiate approach. Follow up consisted of radiological examination and functional assessment using Merle d’ Aubigne score.

Results: 53 conservatively treated patients followed up. 39 (73.6%) had excellent and good results and 14 (26.4%) fair and poor results due to excessive fracture comminution, severe osteoporosis, or they were too sick to be operated on.

83 operatively treated patients with 85 fractures were followed-up. Anatomic reduction was achieved in 57 fractures, satisfactory in 18 and poor in 10 fractures.

Functional outcome was excellent or good in 60 (72.3%) patients and fair and poor in 23 (27,7%).The complications were 3 wound infections, 4 cases of femoral head osteonecrosis, 3 cases of secondary loss of reduction and 5 cases of significant ectopic ossification.

Conclusion: The outcome of these difficult fractures depends on restoration of hip joint congruity and stability and correlates closely to radiographic result.