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Acetabular fractures frequently result in complex structural changes in the hip region, and often require surgical intervention. The medical professionals at Cedars-Sinai Marina del Rey Hospital offer various treatment options for acetabular fractures, depending on the severity and type of the injury. We also offer postoperative treatments for patients who have undergone surgery for acetabular fractures, which can help shorten the recovery period and alleviate discomfort and pain.
The hip joint functions like a ball and socket. The acetabulum (the socket) and the femur (the ball) meet to form one of the most important joints in our body. The hip joint is responsible for the pelvic inclination angle (the pelvis’s orientation in relation to our thigh bones and body) and for maintaining a lot of our body weight. An acetabulum fracture is a severe but rare injury, often caused by a high-energy event, such as a car crash. This type of fracture usually accompanies other injuries. As with any fracture, people with a lower bone density can suffer an acetabular fracture from as little as a fall from a standing position.
Most often acetabular fractures require surgery; however, less severe fractures can be treated non-surgically through physical therapy.
The most common surgery used in cases of acetabular fractures is called ORIF, or open reduction and internal fixation surgery.
Acetabular fractures, usually caused by high-impact incidents, make this surgery one of the most challenging procedures that an orthopedic surgeon can perform due to the severity of the breakage.
This surgery involves straightening (traction) the femur to reposition any free articular fragments and the femoral head (the ball part of the joint) so that reduction and fixation may happen.
Reduction and fixation are the procedures, which aim to restore the broken acetabulum (reduction) and then, using screws and plates, hold the broken fragments in place so that the bone may heal (fixation).
In very severe cases, a total hip replacement surgery may be used to treat an acetabular fracture.
Total hip replacement is used in situations where the acetabulum is so damaged that neither reconstruction nor repair would yield good long-term results.
Screw and plate fixation is used whenever possible so that the bones can be realigned into their normal position before hip replacement.
During a total hip replacement, surgeons will remove the broken acetabulum and replace it with a prosthesis, or artificial hip.
Other therapies include:
Occupational Therapy (OT) can help a patient continue daily activities while recovering from surgery.
Acetabular fractures are most commonly classified based on the Judet and Letournel classification system, which divides them into five elementary fractures and five associated fractures.
The five elementary fractures are:
In general, column fractures divide the acetabulum vertically and transverse fractures divide it horizontally.
Symptoms of an acetabular fracture include:
Acetabular fractures are diagnosed with the use of imaging tests, such as X-rays and CT scans.
X-rays are taken from multiple angles so that a doctor may see the fracture’s pattern and bone displacement, or how out of the position the bones are.
Computed tomography scans (CT scans) are commonly ordered due to the pelvis’s complicated anatomy. A CT scan gives a doctor a better understanding of the specific fracture by providing them with a cross-sectional view of the hip, which helps in the planning of a surgery.
In younger patients, acetabular fractures are usually caused by some type of high impact event, such as a high-speed car collision. In the elderly, acetabular fractures are often caused by weak or insufficient bone matter. This is common when bones have become weakened by osteoporosis.
Alternative treatments for acetabular fractures are very limited and serve mostly as alternative treatment for post-operative therapy.
Fractures can be treated in many ways. When it is possible, your doctor will always suggest a non-invasive treatment before a surgical intervention.
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