Abstract：Objective To analyze the results and prognostic factors of acetabular posterior wall fractures treated by open reduction and internal fixation(ORIF).Methods A total of 121(121hips) patients with displaced acetabular posterior wall fractures were treated by ORIF between February 2002 and February 2015.The clinical functional outcome was evaluated with use of the modified Merle D’Aubigne-Postel score(MDAP).Harris Hip Score(HHS)，and the Short Form-36 Health Survey(SF-36) questionnaire were used for the clinical functional outcome measures.Matta's criteria and Matta's radiologic criteria were used as reduction grades and degeneration of hip joint，respectively.Patients，fractures and radiographic variables were analyzed to identify possible relationships with functional and radiographic outcome.Results All of 121 patients were followed up for 11 to 168 months with a mean of(53.5±27.8) months.There was anatomical reduction in 114 hips(94.2％) and satisfactory in 7 patients(5.8％).Mean modified MDAP were(16.9±5.6)points，with a good-to-excellent rate of 86.7％.Mean HHS was(91.9±12.7)points.The SF-36 score was similar to the normal reference population.Multivariate analysis identified three independent predictors of modified MDAP，HHS，and physical component summary score：associated injuries，preoperative nerve palsy，and age at trauma.Multivariate analysis identified two independent predictors of degeneration of hip joint：early reduction of dislocation(c＝0.6，P＝-0.022)，reduction of fracture quality(c＝1.7，P＝0.027). Conclusion ORIF for treatment of posterior wall of the acetabulum，can achieve a satisfactory clinical functional and radiographic results in most patients，with high levels of satisfaction and quality of life.Anatomic reduction of fracture and early reduction of dislocation is key factor to achieve good functional outcomes and to prevent the traumatic arthritis in the hip joint.The associated injuries and preoperative nerve palsy experience are key factor to leading to worst functional outcomes and quality of life.
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