FRACTURES OF ACETABULUM

Nomin-Erdene.D
• Occurs when the head
of the femur is driven
into the pelvis.

• Combine with
complexities of pelvic
fractures and joint
disruption
 Patterns of the fracture

• 1. Anterior wall
• 2. Anterior column
• 3. Posterior wall
• 4. Posterior column
• 5. Transverse column
• 6. T-shaped fracture
 Clinical features
• Severely shocked
• Severe pain
• Bruising around the hip and limb
• No attempt should be made to move the hip
• Do neurological exam
Imaging

• At least 4 x-ray views

– AP view
– Pelvic inlet view
– Two 45 degrees oblique
view
 Treatmen
t
Emergenc Non-
y operativ
treatment e
Operative
 Emergency treatment
• The first priority is to counteract shock and
reduce a dislocation.
• Skeletal traction is then applied to the distal
femur (10 kg will suffice) and during the next
3–4 days the patient’s general condition is
brought under control.
• Occasionally, additional lateral traction
through the greater trochanter is needed for
central hip dislocations.
 Non-operative treatment
• Walking aids. To avoid bearing weight on your
leg: use crutches or a walker for up to 3
months—or until your bones are fully healed.
• Positioning aids. May restrict the position of
your hip, limiting how much you are allowed
to bend it. A leg-positioning device, such as an
abduction pillow or knee immobilizer.
• Medications. NSAID, an anti-coagulant
 Operative treatment
• Timing of surgery – few days until stable
• ORIF
• THR
 Complication

Iliofemoral Heterotopi
Sciatic nerve
venous c bone
injury
thrombosis formation

Avascula
Secondary OA
r
necrosis