Acetabular Fracture

Acetabular Fracture

An often complex fracture which can be divided into two broad clinical groups based on the patient’s age and energy of impact, with high energy fractures being more common in younger patients and often linked to vehicular accidents and low energy fractures occurring in older patients. The acetabulum is anatomically comprised of two columns (anterior and posterior) and two walls (anterior and posterior); these form the basis of fracture anatomy which Letournel and Judet divided into:
Simple (elementary) type
Anterior wall
Anterior column
Posterior wall
Posterior column
Transverse
Associated types
T-shaped
Anterior wall/column plus posterior hemitransverse
Transverse plus posterior wall
Posterior column plus posterior wall
Both-columns
Classification The Universal Comprehensive Classification has received the approval of the International Society of Orthopaedic Surgery and Traumatology (SICOT) and other bodies and can be used to compare cases at different centres.
Management Integrity of the joint is essential to minimise future dysfunction; if closed reduction fails, open reduction is required and entails anatomic reduction, which is not always successful.
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References in periodicals archive ?
Indications and technical challenges of total hip arthroplasty in the elderly after acetabular fracture.
Abdominal CT revealed lacerations of the spleen and liver in addition to perirenal hematoma and left acetabular fracture.
One case report describes the relatively close scheduled surgeries of a below-knee amputation for osteomyelitis of the right heel, followed by ipsilateral THA for posttraumatic osteoarthritis secondary to an acetabular fracture [11].
The only prior literature describing strain of both the obturator internus and externus was seen on MRI after posterior hip dislocation and was associated with quadratus femoris strain, acetabular fracture and avulsion of the lesser trochanter (3).
Sacroiliac disruption, acetabular fracture on left side.
The complication profile was even higher in another study evaluating complications of acetabular fracture surgery in morbidly obese patients (BMI [greater than or equal to] 40) [19].
With the exception of irreducible dislocations, surgical indications include nonconcentric reductions with intra-articular fragments of cartilage or bone, associated fracture of the femoral neck or femoral head, and associated acetabular fracture combined with hip joint instability.
Traumatic hip dislocation with associated femoral neck fracture in the absence of an acetabular fracture is a rare and challenging injury.
Injury of the femoral nerve associated with acetabular fracture," J.
In addition one acetabular fracture was sustained requiring open reduction and internal fixation.
Judet views and computer tomography (CT) scanning are needed to classify the type of acetabular fracture and to guide treatment (Dandy & Edwards 2004).