Baumgaertner's 1999 JAAOS review examines the assessment, surgical management, and outcomes of isolated posterior-wall acetabular fractures — the most common acetabular fracture pattern — with emphasis on fracture subtypes, stability thresholds, operative technique, and complication avoidance.
When you see a posterior-wall acetabular fracture, use CT to quantify wall involvement before committing to nonoperative care — anything ≥50% is unstable and needs fixation, and even 'simple' patterns are frequently comminuted with marginal impaction that requires elevation, bone grafting, and buttress plating rather than screws alone.
Counsel patients that surgical outcomes are worse here than for most complex acetabular patterns, and always identify and protect the sciatic nerve before placing any implant.
Baumgaertner's 1999 JAAOS review examines the assessment, surgical management, and outcomes of isolated posterior-wall acetabular fractures — the most common acetabular fracture pattern — with emphasis on fracture subtypes, stability thresholds, operative technique, and complication avoidance.
When you see a posterior-wall acetabular fracture, use CT to quantify wall involvement before committing to nonoperative care — anything ≥50% is unstable and needs fixation, and even 'simple' patterns are frequently comminuted with marginal impaction that requires elevation, bone grafting, and buttress plating rather than screws alone.
Counsel patients that surgical outcomes are worse here than for most complex acetabular patterns, and always identify and protect the sciatic nerve before placing any implant.