{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:27:22Z","timestamp":1760142442387,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The management of severely comminuted acetabular posterior wall fractures in young, active patients presents a significant surgical challenge. When anatomical open reduction and internal fixation (ORIF) is not feasible, primary total hip arthroplasty (THA) is often considered but is a suboptimal solution due to concerns over long-term implant survivorship and the inevitability of revision surgery. This single-patient technical note presents a novel joint-preserving technique for managing unreconstructible acetabular posterior wall fractures using with cement-augmented screw fixation via the Kocher\u2013Langenbeck approach. A 28-year-old male sustained a left posterior hip dislocation with a comminuted acetabular posterior wall fracture involving &gt;30% of the articular surface, alongside a tibial shaft fracture, following a high-energy motorcycle collision. Intraoperative assessment confirmed the posterior wall was unreconstructible, with six non-viable osteochondral fragments. A joint-preserving salvage procedure was performed. After debridement, a stable metallic framework was created using three screws anchored in the posterior column. Polymethylmethacrylate (PMMA) bone cement was then applied over this framework in its doughy phase, meticulously contoured to reconstruct the articular surface. The hip was reduced, and the tibia was fixed with an intramedullary nail. The patient was mobilized with weight-bearing as tolerated on postoperative day 3. At the 21-month follow-up, the patient reported no pain during daily activities and only mild discomfort during deep squatting. Radiographic and CT evaluations demonstrated a stable hip joint, concentric reduction, well-maintained joint space, and no evidence of implant loosening or osteolysis. Level of Evidence: V (Technical Note\/single-patient Case report). For unreconstructible, comminuted fractures of the non-weight-bearing portion of the acetabular posterior wall in young patients, cement-augmented screw fixation offers a viable joint-preserving alternative to primary THA. This technique provides immediate stability, facilitates early mobilization, and preserves bone stock. While long-term outcomes require further study, this case demonstrates excellent functional and radiographic results at 21 months, presenting a promising new option for managing these complex injuries.<\/jats:p>","DOI":"10.3390\/life15101573","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:31Z","timestamp":1760028871000},"page":"1573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cement-Augmented Screw Fixation for Unreconstructible Acetabular Posterior Wall Fractures: A Technical Note"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-9856","authenticated-orcid":false,"given":"Jihyo","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8746-3718","authenticated-orcid":false,"given":"Yonghyun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea"},{"name":"Incheon Terminal Orthopedic Surgery Clinic, Incheon 21574, Republic of Korea"},{"name":"International Academy of Regenerative Medicine, Incheon 21574, Republic of Korea"},{"name":"MSKUS, 1035 E. Vista Way #128, Vista, CA 92084, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-829X","authenticated-orcid":false,"given":"King Hei Stanley","family":"Lam","sequence":"additional","affiliation":[{"name":"MSKUS, 1035 E. Vista Way #128, Vista, CA 92084, USA"},{"name":"The Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong"},{"name":"Board of Clinical Research, The International Association of Musculoskeletal Medicine, Kowloon, Hong Kong"},{"name":"The Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S121","DOI":"10.1016\/8756-3282(95)00492-0","article-title":"Epidemiology of hip fractures: Implications of the exponential increase with age","volume":"18","author":"Melton","year":"1996","journal-title":"Bone"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/00005131-200310000-00005","article-title":"The \u201cGull Sign\u201d: A harbinger of failure for internal fixation of geriatric acetabular fractures","volume":"17","author":"Anglen","year":"2003","journal-title":"J. Orthop. Trauma"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Letournel, E., and Judet, R. (1993). Fractures of the Acetabulum, Springer.","DOI":"10.1007\/978-3-642-75435-7"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.2106\/00004623-199611000-00002","article-title":"Fractures of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after injury","volume":"78","author":"Matta","year":"1996","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.injury.2007.12.004","article-title":"Total hip replacement for acetabular fractures. Results in 121 patients operated between 1983 and 2003","volume":"39","author":"Sermon","year":"2008","journal-title":"Injury"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.2106\/00004623-200009000-00017","article-title":"Primary total hip arthroplasty after acetabular fracture","volume":"82","author":"Mears","year":"2000","journal-title":"J. Bone Jt. Surg. Am. Vol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"752","DOI":"10.2106\/00004623-200205000-00008","article-title":"Results of operative treatment of fractures of the posterior wall of the acetabulum","volume":"84","author":"Moed","year":"2002","journal-title":"J. Bone Jt. Surg. 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Bone Jt. Surgery. Am. Vol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.2106\/JBJS.K.00444","article-title":"Two- to twenty-year survivorship of the hip in 810 patients with operatively treated acetabular fractures","volume":"94","author":"Tannast","year":"2012","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/145749690609500206","article-title":"Cement Augmentation in Fracture Treatment","volume":"95","author":"Larsson","year":"2006","journal-title":"Scand. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/j.jbiomech.2009.02.005","article-title":"Potential for thermal damage to articular cartilage by PMMA reconstruction of a bone cavity following tumor excision: A finite element study","volume":"42","author":"Radev","year":"2009","journal-title":"J. Biomech."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T10:01:41Z","timestamp":1760090501000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":17,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["life15101573"],"URL":"https:\/\/doi.org\/10.3390\/life15101573","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2025,10,9]]}}}