The classical (traction) method employed in the treatment of severe central fractures of the acetabulum has frequently resulted in incomplete reduction, because it fails to affect the inner table of the pelvis. This lack of restitution of fragments has produced painful and limited arthritic hips.
A twenty-one-year-old woman, with a central fracture of the acetabulum and marked displacement of the fragments was treated by open reduction and internal fixation with a stainless-steel plate. The plate was placed subperiosteally in the iliac fossa.
When last seen, the patient had a hip which was freely movable without pain.
The author does not recommend that every central fracture of the acetabulum should be treated by open reduction or should be plated. The patient should be given a trial with traction, turnbuckle casts, or any other conservative method, and, if these fail within a week or ten days, an open reduction should be done in order to minimize the future disability, which invariably results from inadequate reduction.