Management of posterior column with posterior wall acetabulum fracture and hip dislocation in a 25-year-old male: Case report

Management of posterior column with posterior wall acetabulum fracture and hip dislocation in a 25-year-old male: Case report - Acetabular fractures involving the posterior column (PC) and posterior wall (PW) are complex injuries commonly associated with high-energy trauma, such as road traffic accidents (RTAs). Such fractures, particularly when combined with posterior hip dislocation, carry a high risk of long-term complications, including avascular necrosis (AVN) and post-traumatic arthritis. This case report presents a 25-year-old male who sustained a PC with PW acetabular fracture and posterior hip dislocation following an RTA. An initial attempt at closed hip reduction failed, and the patient underwent open reduction and internal fixation (ORIF) within six hours of trauma. During surgery, a free posterior column fragment was found inside the joint, which was anatomically reduced and fixed with a posterior column plate, posterior wall plate, and an interfragmentary screw. Postoperative management involved DVT prophylaxis and early mobilization with partial weight-bearing at six weeks and full weight-bearing at 12 weeks. At the four-month follow-up, the patient showed excellent functional recovery with no complaints, and radiographs confirmed fracture union without signs of AVN or arthritis. This case emphasizes the importance of timely intervention, anatomical reduction, and structured rehabilitation in successfully managing complex acetabular fractures. Keywords: Acetabular fractures, Hip dislocation, Posterior column, Posterior wall, Avascular necrosis (AVN), Open reduction internal fixation (ORIF), Post-traumatic arthritis.