Hip Pelvis.  2013 Sep;25(3):158-165. 10.5371/hp.2013.25.3.158.

Treatment of the Acetabular Fracture

• Lee SJ
• Lee SH

• KMID: 1974370
• DOI: http://doi.org/10.5371/hp.2013.25.3.158

Abstract

Acetabular fractures resulting from a high-energy injury show variable forms according to each fracture mechanism, and are composed of complex anatomical structures. Plain radiographs accompanying three-dimensional computer tomography is inevitable, because it is necessary to perform a multidirectional imaging analysis as a diagnosis. Conservative treatment, open reduction with internal fixation, percutaneous screw fixation, and primary artificial hip replacement can be performed. Despite the various treatment methods to the associated injuries, such as comminuted fracture, articular surface injury, poor bone quality and etc, are huge burden for the treatment. Further, there are varying complications, such as thromboembolism, post-traumatic osteoarthritis, avascular necrosis, infection, nerve palsy, heterotopic bone formation and etc. Therefore, physicians need to an accurate classification of fracture and be able to provide rehabilitation, as soon as possible, after rigid internal fixation via open anatomical articular reduction. also In addition, physicians must also pay great attention to prevent complications.

Keyword

Acetabular fracture; Treatment

MeSH Terms

Acetabulum*
Fractures, Comminuted
Hip
Necrosis
Osteoarthritis
Osteogenesis
Paralysis
Thromboembolism

Figure

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  Fig. 1 Algorithm for treatment of the acetabular fracture.

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  Fig. 2 59-year-old female. (A) Preoperative pelvis anteroposterior radiograph shows an acetabular fracture. (B) 3D computed tomography demonstrates anterior wall fracture. (C) Radiograph obtained 1 year postoperatively demonstrates excellent clinical and radiological results.

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  Fig. 3 62-year-old male. (A) Preoperative pelvis anteroposterior radiograph shows a posterior wall fracture. (B) 3D computed tomography demonstrates comminuted posterior wall fracture. (C) Radiograph obtained 2 years postoperatively demonstrates good results.

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  Fig. 4 28-year-old female. (A) Preoperative pelvis anteroposterior radiograph shows a right hip fracture and dislocation. (B, C) 3D computed tomography demonstrate T-shaped fracture. (D) Postoperative pelvis anteroposterior radiograph demonstrates a good reduction and secure fixation through the Kocher-Langenbeck approach and the ilioinguinal approach. (E) 3D computed tomography obtained 1 year postoperatively demonstrates excellent results.

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