This document summarizes the management of 13 acetabular fractures seen by the author between 2002-present. Most fractures were posterior wall or posterior column fractures resulting from motor vehicle accidents. Surgical treatment involved open reduction and internal fixation using plates and screws. Post-operatively, patients underwent rehabilitation and were evaluated using the Harris Hip Score, with most achieving excellent or good results. Complications included myositis ossificans and re-fracture in one case. The author concludes that pre-operative CT planning and specialized surgical techniques and implants like the hooked buttress plate facilitate anatomic reduction and fixation of these complex fractures.

1. Acetabular fractures Dr.A.K.Venkatachalam MS(Orth),DNB(Orth),FRCS,MCh.Orth(Liverpool) Senior Specialist Orthopaedics Ibri regional hospital, Oman

2. My tenure at IBRI HOSPITAL is from 01 July 2002

11. Personality of the fracture

12. Illustration of fracture types(Letournel)

15. Classification of Non operated fractures in this series A1 β 3 Dr.S B 1 +A1(undisplaced) KK A1(No follow up, <June 2002) SK A1 β 3Not available for follow up<June 2002) SSA A1 NMG LAMA (X-rays not traceable) KSK B1 +A1 β 3 IMK

24. Harris hip scores of non operated patients 70.92 (Fair) KK (Undisplaced fracture) 100 Excellent (Pipkin type II femoral head fracture) Dr.SM (undisplaced fracture) 96 NM (Operation refused by patient)

28. Case 1cont’d

29. Case 1 cont’d

30. Case 1 cont’d

31. Case 1cont’d

32. The Spring plate or hooked buttress plate (Jeff Mast)

33. Showing the curvature of the posterior wall and the necessity to contour the plates

34. Columns of Acetabulum

35. Application of the hooked plate and contouring the recon plate

36. Case 1 cont’d

37. Case 1cont’d

38. Case 1 cont’d

39. Case 1 cont’d Harris hip score-96 at 4.5 months follow-up

41. Case 2 cont’d

42. Case 2 cont’d 3 D C T reconstruction

43. Case 2 cont’d post reduction Ischial view

44. Post op X-ray case 2

45. Showing position of screws in the anterior column

46. Pathomechanics in transverse fractures

47. Manipulation of the posterior column

48. Union of the fracture at 4 months.

49. Case 2 cont’d Harris hip score at 4 months-92

51. Trick photo showing the bilateral fractures and the intra-articular bone on the left

52. Case 3 cont’d

53. Case 3 cont’d at 4 months

54. Case 3 cont’d Harris hip score 89(Good)

55. Case 4 25 female A 1 β 3 Harris hip score at 3.5 months-92

57. Case 5 Post-op x ray

58. Case 5 showing incongruent position, refracture through the dome and posterior wall.

59. Case 5 cont’d union of refracture after revision hooked buttress plating

60. Case 5 cont’d showing union of the fracture

68. Fossils showing that life is not as we thought that it was

69. More fossils

72. Thank you