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Pelvis Acetabulum Fractures

Introduction

The hip is made up of a ball and socket joint. The socket is formed by the cup-shaped acetabulum, in which the round head of your thigh bone (femur) attaches. This ball and socket joint helps us to walk, jump and run.

A fracture to the acetabulum is a grave injury that can cause debilitating pain and disability. This type of hip fracture does not occur very commonly. These fractures can affect the smooth surface of the acetabulum and the proper fit of your hip joint, and may necessitate surgical repair and long-term physical therapy.

Causes

Acetabular fractures commonly occur in active people from high-energy trauma caused by motor vehicle accidents and falls from significant heights. They can also occur in the elderly, especially women, due to the weakening of bones from a condition called osteoporosis.

Symptoms

Symptoms of an acetabular fracture may include any or all of the following:

  • Debilitating pain and swelling in your hip or groin areas
  • Pain putting weight on the affected leg
  • Deformity
  • Inability to get up after a fall

Diagnosis

Your doctor can diagnose your acetabular fracture by examining the abnormal position of your hip and legs. Your doctor may also obtain an x-ray to confirm the extent and location of your fracture. If your fracture is too small to come up on an x-ray, you may be recommended to undergo a CT (computed tomography) or MRI (magnetic resonance imaging) scans. The type of fracture, the stability of hip region, and the extent of bone displacement will be determined before suggesting treatment.

Treatment

Conservative Treatment

Conservative treatment will be recommended by your doctor if your bones are not dislocated and your hip is stable. Treatment is usually in the form of skeletal traction to keep the bones in the correct position. Your doctor may realign the bones under anesthesia, without an open surgery.

Treatment may also involve effective pain management, frequent follow-up during the healing phase with appropriate imaging studies and blood work, functional physical therapy, and deep vein thrombosis (DVT) prophylaxis.

Operative Treatment

Surgery involves Open Reduction Internal Fixation (ORIF) of the acetabular fracture. During ORIF, your surgeon will make an incision to expose the broken bone and use special tools to directly manipulate and realign the fracture segments. Depending on the severity of your fracture, wires, plates, or screws may be used to provide a stable fixation. ORIF helps restore the smooth surface of your acetabulum and can be effective in restoring the stability and congruency of your hip joint.

Complications

Acetabular fracture can be a debilitating injury. It can severely reduce your mobility and quality of life, and lead to any of the following complications:

  • Deep vein thrombosis (blood clots in the legs)
  • Pulmonary embolism (blood clots in the lungs)
  • Respiratory illnesses
  • Pressure sores or bedsores
  • Heterotopic ossification (formation of bone in place of muscle)
  • Damage to femur head
  • Arthritis
  • Infection at site of injury

Rehabilitation

Following the surgery, your activities will be restricted for the first six weeks. More aggressive strengthening and range of motion exercises will be practiced over the next six weeks, which will then be followed by strengthening, conditioning, and flexibility exercises thenceforth.

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