Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 9, pp 1223–1234 | Cite as

Outcomes are equivalent for two-column acetabular fractures either with or without posterior-wall fractures

  • Byung-Woo Min
  • Kyung-Jae Lee
  • Jae-Won Jung
  • Gyo-Wook Kim
  • Kwang-Soon Song
  • Ki-Cheor Bae
  • Si-Wook Lee
Trauma Surgery



It is likely that posterior-wall involvement in association with two-column fractures plays a pivotal role in outcomes because of the potential for hip instability if it is not anatomically reduced and fixed. Uncertainty remains about how this fracture is best treated, especially regarding how posterior-wall involvement may affect functional results.

Materials and methods

To better understand the role that posterior-wall involvement may play in determining functional results, we compared data for outcomes for patients with posterior-wall involvement and for those without in a consecutive series of two-column fractures. Between 2000 and 2013, 42 patients who underwent surgical treatment for two-column acetabular fractures were evaluated after a minimum follow-up period of 1 year. Data were prospectively collected and retrospectively evaluated. Of the 42 patients, 25 had only a two-column fracture (group 1) and 17 had a two-column fracture with posterior-wall involvement (group 2).


There were no differences between groups in terms of reduction accuracy, radiographic results, clinical results, or complication rates. All hips in patients with internal fixation for the associated posterior-wall fracture had anatomical reduction. At the latest follow-up evaluation, three patients from group 1 (without posterior-wall involvement) and three patients from group 2 (with posterior-wall involvement) had undergone total hip arthroplasty.


These results suggest that a posterior-wall fracture in a two-column fracture does not compromise functional outcomes when the treatment algorithm discussed here is followed.


Acetabulum Two-column fracture Posterior-wall fracture Ilioinguinal approach 



Medical editor Katharine O’Moore-Klopf, ELS (East Setauket, NY, USA) provided professional English-language editing of this article.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article had obtained approval of the Medical Center’s Institutional Review Board.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, School of MedicineKeimyung UniversityDaeguSouth Korea

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