Acetabular fractures represent one of the most challenging injuries in orthopedic trauma due to their three-dimensional complexity and critical neurovascular structures such as sciatic nerve and iliac vessels. Although these fractures are relatively rare, occurring in about three cases per 100,000 people each year, improper management can lead to serious complications, including post-traumatic osteoarthritis, avascular necrosis, and chronic disability [[1], [2], [3]]

The fundamental principles of acetabular fracture management—anatomical reduction, stable fixation, and early rehabilitation—were established by Judet and Letournel and remain valid today [4] Although the Kocher–Langenbeck and ilioinguinal approaches are the most common, the modified Stoppa and anterior intrapelvic (AIP) approaches have become more popular due to their less invasive nature and reduced rates of complications [[5], [6], [7]]

Traditional plating fixation provides rigid stability but requires extensive soft-tissue dissection, which is often associated with increased blood loss, heterotopic ossification, and risk of neurovascular injury [8,9] The wiring technique involves passing cables through the greater and lesser sciatic notches to compress anterior and posterior acetabular columns. This method was developed to address previous limitations. This method enables indirect reduction of both columns with minimal periosteal stripping and better preservation of the surrounding soft-tissue envelope.

Our group previously reported the surgical technique and short-term outcomes of this wiring method, which demonstrated satisfactory reduction quality and favorable clinical results in the early postoperative period [10] Despite these promising short-term findings, evidence about the mid-term durability of this technique is still limited.

Therefore, the purpose of this study was to evaluate the mid-term clinical and radiologic outcomes of acetabular column fractures treated with the wiring technique and to analyze factors influencing hip joint preservation and survivorship over time.