Tornetta's 2001 review addresses how to decide between operative and nonoperative treatment for displaced acetabular fractures, arguing that surgery should be the default and nonoperative management requires meeting specific radiographic and dynamic stability criteria.
50% posterior wall intact on all CT sections — all must be met before nonoperative management is considered
When you encounter a displaced acetabular fracture, treat it as operative until proven otherwise: work through the Olson-Matta radiographic checklist, then confirm hip stability with a fluoroscopic stress view under anesthesia — only patients clearing both hurdles are candidates for nonoperative management with early mobilization.
If your institution lacks acetabular surgery expertise, this framework also defines when transfer is the right call.
Tornetta's 2001 review addresses how to decide between operative and nonoperative treatment for displaced acetabular fractures, arguing that surgery should be the default and nonoperative management requires meeting specific radiographic and dynamic stability criteria.
50% posterior wall intact on all CT sections — all must be met before nonoperative management is considered
When you encounter a displaced acetabular fracture, treat it as operative until proven otherwise: work through the Olson-Matta radiographic checklist, then confirm hip stability with a fluoroscopic stress view under anesthesia — only patients clearing both hurdles are candidates for nonoperative management with early mobilization.
If your institution lacks acetabular surgery expertise, this framework also defines when transfer is the right call.