Acetabular Fractures

Question 1

Acetabular fractures involving involving dislocation of the femoral head occurs when

Answer 1

a force is transmitted through the femur and can occur from a fall on the side or from a force applied through the line of the femur (i.e. car dashboard in a motor vehicle accident) or from a fall from a height

Question 2

Anterior Column?

Answer 2

Stretches from the anterior inferior iliac spine to the pubis

Includes the anterior part of the acetabular floor.

This type of fracture is relatively uncommon compared to a posterior column fracture

Question 3

Posterior Column?

Answer 3

The posterior column runs from the ischial tuberosity to the sciatic notch and includes the posterior part of the ace tabular floor

This type of fracture is more common

Question 4

Both Columns?

Answer 4

This is when both columns (anterior and posterior) are fractured. This is more common than that of an anterior column fracture

Question 5

Acetabular floor fracture?

Answer 5

The degree of damage is important in order to manage the fracture well

There is a risk of post traumatic arthritis with this kind of fracture

Question 6

What is the classification (AO) of acetabular fractures?

Answer 6

Type A (one column involved)
Type B (main fracture line is transverse, part of the roof of the acetabulum is still conected to the ilium)
Type C This is where there is a fracture involving both columns

Question 7

If there is minimal displacement or the fragments are highly fragmented how is the fracture managed?

Answer 7

It may be managed conservatively with traction for 6 weeks. Active hip movements are allowed and weight bearing is delayed until approximately 9 weeks

Question 8

When is open reduction and internal fixation indicated?

Answer 8

When there is a fracture of one or both columns with displacement of >2mm or gross comminution

Question 9

When may external fixates be applied?

Answer 9

Sometimes, usually when the fracture involves both columns