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Pelvi-acetabular Surgery


What is an acetabular fracture?

An acetabular fracture is a break in your hip socket. Your hip is a “ball-and-socket” joint. Your acetabulum, which is part of your pelvis, forms the socket. Your femoral head, which is the upper end of your femur (thigh bone), forms the ball. The ball-and-socket joint allows movement between your thigh bone and your pelvis. This joint is what lets you walk.

An acetabular fracture can cause a significant loss of motion and function. Acetabular fractures are much less common than most hip fractures. Most hip fractures are in the upper femur or femoral head.

What are the different types of acetabular fractures?

Acetabular fractures can occur on your left or right. Your acetabulum can break in different places and in different ways called patterns. These patterns are based on location, orientation or in a combination. Acetabular fractures include:

  • Anterior wall fractures: An anterior wall acetabular fracture is a break in the front column of bone or area around the bony rim (wall) of your hip socket.
  • Posterior wall fractures: A posterior wall acetabular fracture is a break in the back column of bone or area around the bony rim (wall) of your hip socket.
  • Transverse fractures: A transverse acetabular fracture means your acetabulum broke at a 90-degree angle or perpendicular to the long part of your bone.
  • Comminuted fractures: A comminuted acetabular fracture means your acetabulum broke into more than two fragments.
  • Stress fractures: An acetabular stress fracture is a small crack in your acetabulum bone. This type of fracture happens because of overuse or repeated stress put on your acetabulum bone.

How is the severity of an acetabular fracture determined?

Sometimes an acetabulum breaks straight across and other times it shatters into pieces. The severity of your fracture depends on the following factors:

  • Number and size of bone fragments.
  • How much each fragment is out of place.
  • Injury to your cartilage.
  • Injury to muscle, tendons, nerves and skin around your hip.

Open or compound fractures (when bone fragments stick out of the skin) are particularly severe because infection can occur in both the bone and the wound.

Knowing the pattern and severity of your fracture can help your healthcare provider determine the correct treatment for you.

Symptoms and Causes

The bones of your pelvis, including your acetabulum, are very strong. It would take a strong force to break them. Acetabular fractures most commonly occur due to high-energy injuries. These injuries include car and motorcycle accidents and falls from significant heights. Acetabular fractures occur due to weakened bones, too. Some older people with osteoporosis get acetabular fractures after simple falls.

What are the symptoms of an acetabular fracture?

An acetabulum fracture causes severe hip pain. The pain is sometimes worsened with movement. If you’ve damaged any nerves, you may feel numbness or a tingling sensation down your leg. You may also feel weakness in your leg.

Diagnosis and Tests

How is an acetabular fracture diagnosed?

Your healthcare provider will examine your pelvis, hips and legs. They may:

  • Ask you to move your ankles and toes, checking for nerve damage.
  • Examine you for other injuries, depending on the cause of your injury.

Your healthcare provider may also request the following imaging tests:

  • X-ray: An X-ray can show which bones in your hip are broken and if the bone fragments are in place.
  • Computed tomography (CT) scan: A CT scan can show the severity of your injury by producing a cross-sectional image of your hip.