Operative intervention

The patient is usually allowed 4-5 days to stabilise before surgery.

An exception is made for posterior column fractures with dislocation of the hip. In this case immediate surgery is required for reduction and stabilization of the fracture.

A posterolateral approach is employed and the fracture fixed with lag screws or buttress plates.

Somatosensory evoked potential monitoring is used to avoid damage to the sciatic nerve.

Prophylactic antibiotics are essential.

The patient is mobilised as rapidly as possible:

• partial weightbearing with crutches after 7 days
• exercises for 3-6 months
• normal function expected after 12 months