| Summary: | Closed reduction and percutaneous internal fixation (CRPIF) for acetabular fractures was introduced as a less invasive alternative to open reduction and internal fixation (ORIF) for moderately displaced fractures. Currently, comparisons of ORIF and CRPIF outcomes are rare. Twenty-three patients treated with CRPIF were matched with patients treated with ORIF based on sex, age, and fracture classification. Surgery-dependent and -independent factors of the in-hospital stay, the conversion rate to total hip arthroplasty (THA), and quality of life were assessed. The ORIF group had a higher preoperative fracture step (<i>p</i> = 0.04) and gull wing sign (<i>p</i> = 0.003) compared with the CRPIF group. Postoperatively, the gap and step size were not significantly different between the groups (<i>p</i> > 0.05). CRPIF required less time (<i>p</i> < 0.0001) and transfusions (<i>p</i> = 0.009) and showed fewer complications (<i>p</i> = 0.0287). Four patients were converted to THA (CRPIF, <i>n</i> = 1; ORIF, <i>n</i> = 3; <i>p</i> = 0.155) because of posttraumatic osteoarthritis. Functional outcomes and pain were similar in both groups (<i>p</i> > 0.05). The present study revealed less blood loss and a lesser extent of reduction in patients treated with CRPIF than in those treated with ORIF. The rates of conversion to THA and functional outcomes did not differ between CRPIF and ORIF. CRPIF appeared to be a valuable treatment option for selected patients.
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