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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
BONE AND JOINT DEFORMITIES - SCIENTIFIC PAPERS 100° CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPAEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Pavia, June 20-21, 2003
Minerva Ortopedica e Traumatologica 2003 April;54(2):111-8
Total hip arthroplasty after acetabular fracture
D’Imporzano M., Pierannunzii L., Fadigati P., De Bellis U.
III Divisione di Ortopedia e Traumatologia, Chirurgia Anca Displasica, Istituto Ortopedico “G. Pini”, Milano
Acetabular fractures are caused by high-violence injuries. As in the management of other joint injuries, the goals in the treatment of these fractures are restoration of integrity and, when possible, anatomic reduction of the cartilage surface in order to allow early mobilization and to prevent post-traumatic osteoarthrosis.
As the number of traffic accidents rise, the orthopedic surgeon is increasingly faced with the problem of treating acetabular fractures. The literature supports the opinion that these injuries are associated with a high percentage of degenerative phenomena resulting from imperfect reduction of the joint surfaces, chondral lesions of the head of femur and/or acetabulum, and osteonecrosis (2-40% of cases).
The elevated incidence of incapacitating sequelae, which are sometimes inevitable despite correct surgical treatment, raises the question of arthroplasty in patients with fracture injuries.
Hip arthroplasty plays a fundamental role in the treatment of patients with osteoarthrosis or femur head necrosis secondary to acetabular fracture and can ensure restoration of joint function and significant reduction of coxalgia.
Unquestionably, acetabular fractures represent a risk factor in the long-term survival of prosthetic devices, particularly when major dysmorphism of the acetabular surface is present or an adequate bone stock is lacking.