![]() ![]() Many studies also emphasize the importance of the surgeon’s experience it has been demonstrated that 19–25 % of fair or poor results may occur following surgeries performed by experienced surgeons, whereas this may increase to 55–56 % when the surgery is performed by less experienced surgeons. This can be more complicated when more than 50 % of the joint surface is involved, which may lead to hip joint instability. The reconstruction of the posterior wall is technically demanding. Comminuted fractures are usually seen in females over 50 years old and in elderly populations due to osteoporosis which increases bone fragility. The second type includes impacted fragments, with or without bone loss. The first type includes free fragments or fragments attached to the joint capsule. According to the Judet classification, this fracture can be divided into two types. This fracture usually occurs in association with posterior hip dislocation, which leads to displacement of bone fragments. The majority of posterior wall fractures are comminuted with impacted fragments, usually in the elderly population. Posterior acetabular wall fracture is the most common type of acetabular fracture, accounting for 47 % of total acetabular fractures, according to Letournel and Judet. This surgical technique seems to be effective and safe in treating a comminuted fracture of the posterior wall in association with an impacted segment. Using an autogenous bone graft to fill the bone defect supplies excellent mechanical stability without any severe complications at the donor site. No other severe complications were detected. Femoral head necrosis was observed in one case. Pain in the zone of graft harvesting was not detected in any patient. The clinical results included one “excellent”, four “very good”, four “good” and one “poor”. Merle d’Aubigne and Postel scoring, modified by Matta, was applied to evaluate the patients during follow-up. ![]() The reduction was achieved through the insertion of the graft above the impacted fracture, and plate fixation was performed subsequently. Autogenous bone grafts from the greater trochanter were used to fill the gap in all patients. Ten patients with comminuted fractures and impacted segments with bone defects were enrolled in our study, from January 2010 to July 2012. The other fragments are fixed following the reduction of the impacted segment. A bone graft should be used to fill the gap. The impacted fragment should be isolated, mobilized, and then reduced. The subchondral bone of the articular zone is compressed and causes a bone defect. Comminuted fractures with an impacted segment represent a subtype of this injury. Posterior wall fracture is the most common acetabular fracture. ![]()
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