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Abstract Objective To compare the clinical results of pre-contoured plates combined with single and multiple antegrade posterior column screw via anterior approach for treatment of both columns acetabular fractures.Methods A retrospective analysis was performed on 33 patients with both columns acetabular fractures treated with pre-contoured plates combine single and multiple antegrade posterior column screw via anterior approach from Jan 2016 to Jun 2022.There were 23 males and 10 females，with an average of (49.8±14.2) years (range，18 to 72 years).Preoperative 3D printing of pelvic model and pre-contoured plates were applied.There were 14 cases in simple posterior column screw group and 19 cases in multiple posterior column screws group.The fracture reduction was assessed with Matta scoring system，and the hip function was evaluated with modified Merle D’Aubigne and Postel scoring system.Results All cases were followed up for 8 to 34 months with an average of (10.3±4.5) months.The acetabular fractures all healed.The operation time，intraoperative blood loss and fluoroscopy time in multiple posterior column screws group were significantly higher than simple posterior column screw group (P＜0.05).No significant difference was found in fracture site healing time between the two groups (P＞0.05).Fracture reduction quality was excellent in 3 cases，good in 9 cases，pool in 2 cases，the excellent and good rate was 85.7% in simple posterior column screw group，and it was excellent in 13 cases，good in 5 cases，poor in 1 case，the excellent and good rate was 94.7% in multiple posterior column screw group.No significant difference was found between the excellent and good rate of fracture reduction (P＞0.05)，but the rate of anatomical reduction in multiple posterior column screw group was significantly higher than simple posterior column screw group (P＜0.05).The hip function was excellent in 4 cases，good in 8 cases，fair in 2 cases，the excellent and good rate was 85.7% in simple posterior column screw group，and excellent in 7 cases，good in 9 cases，fair in 3 case，the excellent and good rate was 84.2% in multiple posterior column screw group.No significant difference was found between the two groups (P＞0.05).Conclusion Pre contoured plates combined with single and multiple posterior column screw via anteriopr approach for treatment of two-columns acetabular fracture have good clinical effecacy.Multiple posterior column screws can get better reduction and fixation.
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