Acetabular reconstruction plate fixation is used for the treatment of acetabular posterior wall comminuted dislocations where closed reduction has failed; posterior wall fracture blocking the femoral head makes satisfactory or difficult-to-achieve concentric reduction possible. Sciatic nerve injury and open acetabular fractures were present. Two cases involved femoral heads where closed reduction had failed, one case after reduction was difficult to maintain concentric alignment, two cases of sciatic nerve injury underwent emergency surgery, and one case after reduction was difficult to maintain concentric alignment but was combined with splenic rupture two weeks post-surgery. Postoperative complications included heterotopic ossification and traumatic arthritis. For acetabular posterior wall and posterior column comminuted fractures, the quality of reduction and internal fixation are strong and reliable determinants of efficacy. The acetabular reconstruction plate's shape is easy to press into bone-shape, its fixed range is flexible, making it convenient to use, providing strong and reliable fixation that protects early joint function. Poorly fixed fractures can lead to load conduction disorders, abnormal stress distribution, causing direct degeneration of articular cartilage. Early continuous passive joint function exercises using the CEVl machine help Lee's acetabular fracture repair and joint surface molding, reducing the incidence of osteoarthritis and traumatic arthritis to 1.5%. The influence of acetabular posterior wall fracture treatment depends not only on the degree of displacement and fracture comminution, timing of surgery, quality of reduction, and strong and reliable internal fixation, but also on age, associated injuries, and complications.