Posterior wall reconstruction using intertrochanteric crest strut graft in comminuted posterior acetabular wall fractures.

Abstract

Posterior wall fractures are the most common acetabular fractures. Despite being frequently the easiest to treat, posterior acetabular wall reconstruction following such injuries can be challenging. A prospective study was conducted to evaluate the efficacy of a new surgical technique using gluteus medius muscle-pedicled intertrochanteric crest graft for the reconstruction of comminuted posterior acetabular wall fractures where primary comminuted fragments were beyond fixation. This technique has been performed on six patients from 2010 to 2012. The radiologic (Matta score) and clinical evaluation (modified Merle d'Aubigne and Postel score) were recorded at their final follow-up. 
The mean follow-up was 15.2 months. The radiological outcome by plain radiographs was graded as anatomical in all six patients, the clinical outcome by modified Merle d'Aubigne and Postel score was considered to be excellent in two patients, good in four. 
Reconstruction of the posterior acetabular wall using gluteus medius muscle-pedicled intertrochanteric crest graft may be appropriate in some instances. The early radiological and clinical results of this new technique were promising.