Acetabular fracture

Acetabular Fracture

An acetabular fracture is a break in the acetabulum, the concave surface of the pelvis that articulates with the femoral head to form the hip joint. These fractures are often the result of high-energy trauma, such as motor vehicle accidents or falls from significant heights.

Anatomy

The acetabulum is a deep, cup-shaped structure located on the lateral aspect of the pelvis. It is formed by the fusion of three bones: the ilium, ischium, and pubis. The acetabulum is divided into several regions, including the anterior wall, posterior wall, and the roof or dome. The acetabular labrum is a ring of cartilage that surrounds the acetabulum, deepening the socket and providing stability to the hip joint.

Anatomy of the acetabulum

Obturator view of the acetabulum

Lateral view of the acetabulum

Classification

Acetabular fractures are classified based on the location and pattern of the fracture. The most commonly used classification system is the Letournel and Judet classification, which divides acetabular fractures into elementary and associated types. Elementary fractures involve a single fracture line, while associated fractures involve multiple fracture lines or combinations of elementary fractures.

Elementary Fractures

• Posterior wall fracture
• Posterior column fracture
• Anterior wall fracture
• Anterior column fracture
• Transverse fracture

Associated Fractures

• T-shaped fracture
• Anterior column with posterior hemitransverse fracture
• Both column fracture
• Transverse with posterior wall fracture

Diagnosis

The diagnosis of an acetabular fracture is typically made using imaging studies. X-rays are the initial imaging modality used to assess the fracture, but computed tomography (CT) scans provide more detailed information about the fracture pattern and are essential for surgical planning.

CT scan of an acetabular fracture

Sagittal view of an acetabular fracture

Treatment

The treatment of acetabular fractures depends on the type and severity of the fracture, as well as the patient's overall health and activity level. Non-surgical management may be appropriate for non-displaced fractures or patients who are not surgical candidates. Surgical intervention is often required for displaced fractures to restore the anatomy of the acetabulum and ensure the stability of the hip joint.

Surgical Techniques

• Open reduction and internal fixation (ORIF)
• Minimally invasive techniques
• Total hip arthroplasty in cases of severe joint damage

Prognosis

The prognosis for patients with acetabular fractures varies depending on the severity of the fracture and the success of the treatment. Complications can include post-traumatic arthritis, avascular necrosis of the femoral head, and heterotopic ossification. Early mobilization and rehabilitation are crucial for optimal recovery.

Related Pages

• Pelvic fracture
• Hip dislocation
• Orthopedic surgery
• Trauma surgery

Gallery

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  X-ray of an acetabular fracture
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  Posterior wall fracture
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  Posterior wall fracture, another view
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  Posterior wall fracture, third view
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  Anterior wall fracture
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  CT scan of an anterior wall fracture

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