Executive Editor: Richard Buckley

Authors: Tania Ferguson, Daren Forward

Acetabulum - Posterior column

back to skeleton

Glossary

General considerations

Nonoperative treatment of the posterior column fracture is unusual. Most posterior column fractures are displaced, and any displacement requires reduction and fixation.

Surgery is urgent for:

  • Irreducible dislocation
  • Increasing sciatic nerve deficit
  • Hip joint incongruity with risk of femoral head damage

ORIF is the optimal operative treatment for most fractures. For severe arthrosis or osteoporosis, total joint replacement should be considered.

Nonoperative treatment
Main indication Skill Equipment
Undisplaced fractures (occur rarely) Highly experienced and skilled surgeon Basic equipment only

Advantages

  • Avoidance of risks of surgery

Disadvantages

  • Control radiographs necessary in the first two weeks
ORIF through Kocher-Langenbeck
Main indication Skill Equipment
All displaced posterior column fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Any displacement of the posterior column requires reduction and fixation.

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2017-11-27