Acetabular, pelvic and femoral head fractures

Question 1

what are the types of acetabular fracture you are aware of?

Answer 1

Letournel and judet

Elementary fractures
- invole only one element of pelvic anatomy
- posterior wall, posterior column
- anterior wall, anterior column
- transverse fracture

Associated fractures
- presence of two or more elementary fractures

Question 2

what are the iliopectineal ilioischial lines?

Answer 2

• iliopectineal - anterior column and posterior wall
• ilioischial - posterior column and anterior wall

Question 3

what is the kocher langenback approach?

Answer 3

lateral position

skin incision
- lateral to PSIS -> anterior to GT -> 10cm distal along femoral shaft

approach
- superficial - split gluteus medius (inferior gluteal nerve and vessels)
- deep - piriformis and short external rotators - leave quadratus femoris

dangers
- sciatic nerve
- inferior/ superior gluteal nerves and vessels

Question 4

pipkin fractures

Answer 4

1. fracture below fovea - NWB
2. fracture above fovea - WB
3. femoral head with neck fracture
4. femoral head with acetabulum fracture