Surgical Anatomy of Acetabulum and Biomechanics

Both column acetabular fractures are challenging articular injuries. Majority of them are treated operatively. The concept of “secondary congruence” was introduced by Letournel. Despite this, biomechanical data on secondary congruence indicate that nonoperative treatment leads to an increase in peak pressures in the supra-acetabular region with the potential risk of developing posttraumatic degenerative osteoarthritis. Operative management is therefore justified. A cohort of 10 patients having both column (anterior and posterior) acetabular fractures managed using bicolumnar plating between Jan 2016 and Dec 2017 were enrolled in the study and were analyzed during follow-up period. Eighty percent of the patients had excellent to good result. Average postoperative score was 85.7. Assessment was done using Modified Harris Hip score.