{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:00:14Z","timestamp":1790168414269,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9,23]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To characterize the rate and risk factors for a posterior wall fragment becoming intra-articular following closed reduction in posterior acetabular fracture-dislocations when the fragment was positioned between the femoral head and acetabulum prior to reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Design<\/jats:italic>\n                      : Retrospective case series.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Regional Level 1 trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Patients with posterior wall, posterior column\u2013posterior wall, or transverse\u2013posterior wall acetabular fracture-dislocations and posterior hip dislocation between January 2019 and December 2023 were reviewed. Inclusion required pre- and post-reduction CT imaging demonstrating a posterior wall fragment between the femoral head and acetabulum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n                    <jats:p>Pre- and post-reduction CT scans were reviewed to define fragment position relative to the femoral head and determine whether fragments were intra- or extra-articular after reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 44 patients with a posterior wall fragment positioned between the femoral head and acetabulum prior to reduction, 21 (47.7%) had the fragment become intra-articular following closed reduction. All fragments that displaced into the joint were medial to the femoral head (100%) prior to closed reduction (mean age 37.4 years [18.0\u201377.0], 57.1% male) and 23 (52.3%) remained extra-articular (mean age 34.3 years [20.0\u201380.0], 65.2% male). Among intra-articular fragments, 21 of 21 (100.0%) were medial to the femoral head before reduction compared with 6 of 23 (26.1%) extra-articular fragments (p&lt;0.001). Inferior fragment position was present in 20 of 21 (95.2%) intra-articular fragments and 8 of 23 (34.8%) extra-articular fragments (OR 37.5, 95% CI 4.2\u2013333.1; p&lt;0.001). Fragment length was 2.6 \u00b1 1.1 cm versus 3.6 \u00b1 1.0.98 cm (p=0.003). Medial fragment position was associated with non-concentric reduction (74.2% vs. 30.8%; OR 6.5, 95% CI 1.6\u201326.9; p=0.015), whereas inferior fragment position was not (p=0.172; OR 2.9, 95% CI 0.8\u201310.9; p=0.172).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Medial and inferior posterior wall fragment position before reduction were each associated with post-reduction intra-articular translation, while medial position was also associated with non-concentric reduction. Recognition of this morphology may aid surgical planning and anticipation of fragment retrieval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Prognostic Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003283","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:00:10Z","timestamp":1790164810000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pre-Reduction Position of Posterior Wall Fragment is Associated with Intra-Articular Displacement"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7616-5683","authenticated-orcid":false,"given":"Connor C","family":"Park","sequence":"first","affiliation":[{"name":"Creighton University School of Medicine \u2013 Phoenix, Phoenix, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn A","family":"Barth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Trauma Surgery, The Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-4248","authenticated-orcid":false,"given":"Christian G","family":"Falgons","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonahs","family":"Galloway","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Lee (Chip) Routt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Kellam","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan G","family":"Eastman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7093-8836","authenticated-orcid":false,"given":"Stephen J","family":"Warner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:00:10Z","timestamp":1790164810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000003283","relation":{},"ISSN":["0890-5339","1531-2291"],"issn-type":[{"value":"0890-5339","type":"print"},{"value":"1531-2291","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}