الفهرس 
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Abstract
Acetabular fractures represent an injury to the articular surface of a major weight bearing joint and should be treated in according with the same criteria used for other intraarticular fractures.
The surgical management of displaced acetabular fractures is indicated for an unstable and an incongruous hip joint.
The acetabulum is formed by two columns of bone, anterior and posterior. These columns converge and meet in a thick and compact portion of bone situated infront of and below the iliac reticular surface of the sacroiliac joint.
The majority of patients with acetabular fractures have been involved in a motor vehicle accident, either in a car or on a motorcycle.
Judet and Letournel, divided acetabular fracture into two major types, elementary and associated or complex; each has its subgroup. They considered the acetabulum to be an arch formed by two columns of bone, one anterior and the other is posterior.
The most definitive indication for surgery is instability of the hip joint.
The type of fracture mainly determines the choice of incision, but other factors also influence the choice. The general trend is towards more limited exposures to avoid the complications of the more extensile ones.
Displaced acetabular fractures are usually associated with significant morbidity and mortality.
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A number of the complications, however, are secondary to surgical treatment; including either immediate post-surgical complications such as infection, nerve injuries thromboembolism and malreduction, and late complications such as heterotopic ossification, avascular necrosis of the femoral head or acetabular fracture fragment, posttraumatic osteoarthritis and implant failure.
The aim of this work is to assess the results of surgical treatment of fractures of the acetabulum.
from January 2003 to March 2005, thirty patients with displaced acetabular fractures were treated by open reduction and internal fixation in Orthopaedic department, Faculty of Medicine, Menoufiya University.
The average patient age at time of acetabular fracture surgery was 33 years, with a range of 18 to 55years. All were ambulatory at the time of injury. There were 26 male patients and 4 females. The right side was affected in 14 patients and the left side in 16 patients.
The mechanisms of the injury were a traffic accident for 24 patients (20 dashboard injuries and 4 pedestrian injuries) and a fall for 6 patients.
The follow up period ranges from twelve months to 36 months.
Based on the Judet and Letournel classification, there were fourteen elemental patterns (six posterior wall, three posterior column and five transverse) and sixteen associated fractures (five T-type, six both column, three T-shaped + posterior wall and two transverse + posterior wall).
Six patients sustained a fracture with dislocation; five posterior and one central. No cases with anterior dislocation. One patient had a
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fracture of the femoral head (Pipkin type IV). The follow up period ranges from twelve months to 36 months.
Seven cases of near perfect reduction (23.3%), sixteen cases with good reduction (53.4%) and seven cases with poor reduction (23.3%). All cases were evaluated radiologically and functionally.
Radiological evaluation includes early and late radiological evaluation. Early radiological results were seven cases of near perfect reduction (23.3%), sixteen cases with good reduction (53.4%) and seven cases with poor reduction (23.3%). Late radiological results were excellent in four cases (13.3%), good in fifteen cases (50%), fair in five cases (16.7%) and poor in six cases (20%).
Functional results were excellent in four cases (13.3), good in fourteen cases (46.7%), fair in six cases (20%) and poor in another six cases (20%).
Intraarticular fragments and acetabular impaction were found in four cases.
Two (50%) cases gave good results while the other two (50%) gave fair and poor results. The difference between patients who had intraarticular fragments and acetabular impaction and those without these findings was found to be significant.
Kocher-Langenbeck appeared the most popular approach used in acetabular fractures treatment as it was used in seventeen cases (56.7%). Transtrochanteric approach was used in ten cases (33.3%), Combined approach in two cases (6.7%) and Extensile Triradiate approach in only one case (3.3%).
Twenty-four (80%) cases were fixed with reconstruction plates while six (20%) cases were fixed with screws alone.
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The average length of hospitalization was 21.2 days, ranged from 5 to 45 days. The mean was 20.5 days.
Early complications included, deep venous thrombosis in three cases (10%), two cases (6.7%) developed sciatic nerve injury, failure of fixation occurred in two cases (6.7%) and infection in three cases (10%).
Late complications included, heterotopic ossification in two cases (6.7%), osteoarthritis occurred in three cases (10%), two cases (6.7%) developed avascular necrosis of the femoral head.