This study evaluated the safety and clinical efficacy of an innovative anatomical locking plate known as the anatomical posterior acetabular plate (APAP) for posterior plating for acetabular fractures. From January 2015 to December 2018, 19 patients who had posterior wall or posterior column fractures and underwent open reduction and internal fixation (ORIF) with the APAP using the standard Kocher–Langenbeck approach were included. Relevant surgical data were collected for clinical evaluation. Reduction quality was graded according to Matta’s radiological criteria. Functional outcomes were evaluated using the modified Merle d’Aubigné scoring system and the Oxford Hip Score (OHS) questionnaire. Satisfactory anatomical reduction was achieved in 16 (84.2%) patients. The final modified Merle d’Aubigné scores were excellent for one hip (5.3%), good for ten hips (52.6%), fair for six hips (31.6%), and poor for two hips (10.5%). The mean OHS was 33.3 (10–44). The incidence of heterotopic ossification, posttraumatic osteoarthritis, and osteonecrosis of the femoral head was 10.5%, 21%, and 26.3%, respectively. The rate of conversion to total hip arthroplasty was 15.8% after 4 years. The results of this study indicate that the APAP provides adequate fixation and satisfactory short-term results in treating posterior acetabular fractures.
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