Acetabular fractures are challenging fractures to treat. Many fracture patterns occur, in a deep anatomical area surrounded by numerous vascular and nervous elements, generally in a polytraumatic context . A reduction with less than 2 mm of incongruence is generally considered acceptable, limiting post-operative osteoarthritis that could rapidly require total hip arthroplasty. Due to the long learning curve, this surgery is limited to large reference centers

. In the last twenty years, the main series published in the literature are small series due to the rarity of the fractures and their trauma context (loss of follow-up, polytrauma patients…). The large variety of fracture patterns according to the Letournel classification creates a spread in patient distribution and decreases the power of statistical analysis. That is the reason why big series are rare and only a few of them allow significant conclusions . The other studies are meta-analyses with their limitations

The lack of consensus makes it difficult to interpret the results between series, so the investigators developed a decision tree to address this knowledge gap.

The aim of this study is to assess and compare the results of a decisional tree for acetabular fracture in a large cohort of patients from a well-known experimental trauma center.

Inclusion Criteria:

• Adult patient at the time of injury
• Acetabular fracture
• Pre-operative standard X-ray image
• Pre-operative CT image
• Post-operative X-ray standard image (AP-alar and obturator views)
• Post-operative CT scan.
• Willingness and ability to participate in the study

Exclusion Criteria:

• Ipsilateral fracture femoral and/or associated pelvic ring fracture (Floating Hip C or B)
• Pregnant, lactating women
• Subject under administrative or judicial supervision

All patients managed between 01/01/2020 and 01/01/2023 for an acetabular fracture in our trauma center are included in this single-center retrospective study.

The epidemiological data, the pre-operative management, the fracture patterns according to the Letournel and AO/OTA classification, the operative data and the radiological criteria (X-rays and CT scans) are retrospectively collected and analyzed.