![]() ![]() At 2-weeks post op, patient was weight-bearing as tolerated with no displacement noted on radiographic imaging. On postoperative day 1, the patient was weight-bearing as tolerated using a hemi walker and released from the hospital the following day. Acetabular fracture surgery realigns and stabilizes the displaced joint surfaces while allowing the patient to avoid traction and prolonged bedrest. The IlluminOss implants were inserted, filled with liquid monomer, and cured using visible light. The anterior column was treated in a standard retrograde fashion, though a much longer construct was made possible by using a flexible implant. This novel corridor is possible only with the use of a flexible implant. The patient was treated operatively through a novel approach to the posterior column traversing down the gluteus medius pillar and curving posteriorly to the acetabulum to go down the posterior column. The patient failed two days of conservative treatment, complaining of significant pain and discomfort and surgical intervention was requested. CT scan revealed a typical geriatric both-column acetabular fracture with mild protrusio. The patient’s past medical history was significant for a previous left hip fracture and left-sided weakness from 2 left sided strokes requiring the use of a hemiwalker. However, intraarticular fragments may be obscured.A 66-year-old male sustained a left acetabular fracture after a fall. Some studies have revealed that MR imaging of acetabular fractures can be used to detect subclinical injury of the sciatic nerve and occult injuries of the femoral head not readily apparent on CT scans. CT scans with coronal and sagittal reconstruction are useful in defining the morphologic characteristics of acetabular disruption. Such assessment must include AP and Judet views (internal (obturator) oblique and external (iliac) oblique views). Because the Letournel scheme is an anatomic classification, acetabular fracture classification easily follows the radiographic assessment. Both-column fracture - all segments of the articular surface are detached from the ilium.Īcetabular fractures must be classified before an appropriate surgical approach can be chosen. Anterior column with a posterior hemitransverse fractureĥ. T-type fracture - combines a transverse component and vertical component that separates the lower ischiopubic segment into the anterior and posterior columns.Ĥ. Transverse with a posterior wall fractureģ. ![]() Posterior column with a posterior wall fractureĢ. The 5 complex patterns are combinations of the simple patterns: (account for 80% of acetabular fractures)ġ. Transverse acetabular fractures - involve both anterior and posterior acetabulum: dividing the innominate bone into superior segment containing acetabular roof and intact ilium, and inferior segment consisting of single ischiopubic fragment. Anterior column fractures - bony strut running from ASIS to superior pubic ramus, and includes anterior wall. It involves not only the posterior articular surfaces, but also the ilioischial line.Ĥ. Posterior column fractures - bony strut running from PSIS to inferior pubic ramus, and includes the posterior wall. Posterior wall fractures - posterior wall fractures always involve posterior articular surfaces, often accompanied by a portion of the retroacetabular surface and sometimes the entire surface. The 5 simple patterns are the following: (account for 20% of acetabular fractures)ġ. The posterior column comprises the greater and lower sciatic notches, the ischial tuberosity, the posterior wall, and the entire retroacetabular surface.Īccording to Judet and Letournel classification and column theory, acetabular fractures are classified into simple and complex patterns. The fracture causes pain in the hip area and the inability to walk without assistance. Acetabular (hip socket) fractures can result from falls, automobile accidents or other traumatic events. The anterior column comprises the anterior border of the iliac wing, the entire pelvic brim, the anterior wall and the superior pubic ramus. Acetabular fracture surgery realigns and stabilizes the displaced joint surfaces while allowing the patient to avoid traction and prolonged bedrest. ![]() ![]() For the purpose of classification of fracture patterns, the acetabulum is divided into an anterior and posterior column. ![]()
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