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ORTHOPEDIC TRAUMA UPDATE PART I
Minerva Ortopedica e Traumatologica 2009 October;60(5):375-90
Copyright © 2009 EDIZIONI MINERVA MEDICA
language: English
Evaluation and treatment of acetabular fractures: an overview
Achor T. S. 1, Lorich D. G. 1, 2, Helfet D. L. 2, 3
1 Orthopedic Trauma Service, Hospital for Special Surgery, New York, NY, USA 2 Orthopedic Surgery, Weill Medical College of Cornell University, New York, NY, USA 3 Orthopedic Trauma Service, New York Presbyterian Hospital, New York, NY, USA
Acetabular fractures are among the most complex injuries an orthopaedic surgeon must treat. These are typically high-energy injuries and are often associated with multi-trauma patients. Once life threatening injuries are addressed, imaging studies should be obtained to classify and characterize the fracture. While nonsurgical management is occasionally warranted, acetabular fractures are generally considered a surgical injury. Evidence of hip incongruity or instability as well as fractures with displacement through the weight-bearing dome or intra-articular fragments are considered indications for surgery. The surgical approach and method of reduction and fixation is dependent on the fracture type and pattern, the patients’ medical status and functional demands, and the surgeons’ comfort level and experience. Newer techniques have been developed in an effort to limit complications and improve patient outcomes. While fixation of these fractures is considered difficult, results can be excellent. Although many factors contribute to satisfactory outcomes, the quality of reduction and avoidance of complications remain paramount.