The majority of acetabular fractures are caused by some type of high-energy event, such as a car collision. Many times patients will have additional injuries that require immediate treatment.
In a smaller number of cases, a low-energy incident, such as a fall from standing, may cause an acetabular fracture in an older person who has weaker bones.
Treatment for acetabular fractures often involves surgery to restore the normal anatomy of the hip and stabilize the hip joint.
A fractured acetabulum is almost always painful. The pain is worsened with movement. If nerve damage has occurred with the injury, the patient may feel numbness, weakness, or a tingling sensation down the leg.
An acetabular fracture results when a force drives the head of the femur against the acetabulum. This force can be transmitted from the knee (such as hitting the knee against the dashboard in a head-on car collision) or from the side (such as falling off a ladder directly onto the hip). Depending upon the direction of the force, the head of the femur is sometimes pushed out of the hip socket, an injury called hip dislocation.
When the fracture is caused by high-energy impact, patients often experience extensive bleeding and have other serious injuries that require urgent attention. Acetabular fractures are sometimes caused by weak or insufficient bone. This is most common in older patients whose bones have become weakened by osteoporosis. Although these patients do not often have other injuries, they may have complicating medical problems, such as heart disease or diabetes.
What is acetabular fracture?
An acetabular fracture is a break in the socket portion of the “ball-and-socket” hip joint.
What is the mechanism of acetabular fracture?
Fractures of the acetabulum occur when the head of the femur is driven into the pelvis. This injury is caused by a blow to either the side or front of the knee and often occurs as a dashboard injury accompanied by a fracture of the femur. Fractures of the acetabulum in young individuals usually result from a high energy injury like vehicular accident or feet first fall. In older individuals or those with osteoporosis, a trivial fall may result in acetabular fracture.
What are the types of acetabular fracture?
Classification of acetabular fracture:
I – Simple fracture, anterior or posterior wall column
II – transverse fracture
III – T – Type fracture involving two columns
IV – Both columns fractures, floating acetabulum
How is acetabular fracture managed?
If the femur head is dislocated, it should be reduced as soon as possible, to prevent damage to its blood supply. This is preferably done under anesthesia, following which, leg is kept pulled by applying traction to prevent joint from dislocating. Surgical fixation using screws and plates may be required if the injury is complex.
What is the recovery time in acetabular fracture?
The patient may be allowed to stand and walk with help of support within about six to eight weeks. Full function may return in about three months.
What are the complications which may arise after the fracture?
Post traumatic arthritis, infection, nerve injury etc.
What are the activities which should be avoided after acetabular fracture?
Do not put weight on the broken side for 3 months, avoid physical activity, etc.
Are there any follow up appointments required after acetabular fracture fixation?
After discharge from hospital, you will usually be reviewed in the fracture clinic at 6 weeks, 12 weeks, 6 months and 12 months after your injury. At each visit you will be seen by a doctor, and x-rays will be taken.
How should be the nutrition during recovery?
During your recovery it is important for you to maintain a healthy diet. Bone fractures can put a lot of stress on the body which means the body needs extra nutrition to help the healing process. Try to ensure a protein and carbohydrate food is included in each of your meals. A balanced diet is one with plenty of variety so include fruit and vegetables too.