Acetabular fracture

Acetabular fracture refers to a break in the acetabulum, the part of the pelvis that forms one side of the hip joint. These fractures are significant due to their potential to impact the congruity of the hip joint and thus affect mobility and stability. Acetabular fractures are often the result of high-energy trauma, such as car accidents or falls from significant heights, and are considered serious injuries requiring prompt and effective treatment.

Causes

The primary cause of acetabular fractures is high-energy trauma. This can include:

• Vehicle accidents - where the knees impact the dashboard, transmitting force directly to the hip joint.
• Falls from height - where the force of landing is transmitted up through the legs to the hip.
• Crush injuries - where the pelvis is compressed or crushed between objects.

Symptoms

Symptoms of an acetabular fracture can include:

• Severe pain in the hip or groin area.
• Difficulty or inability to stand or walk.
• A feeling of the hip being unstable or "giving way".
• Bruising and swelling in the hip area.

Diagnosis

Diagnosis of an acetabular fracture typically involves:

• Medical history and physical examination.
• Imaging studies such as X-rays to visualize the fracture, and CT scans to provide more detailed images of the bone structures and to help in planning surgery if needed.
• MRI may also be used to assess any damage to the surrounding soft tissues.

Treatment

Treatment of acetabular fractures depends on the severity and type of the fracture but can include:

• Non-surgical treatment, which may involve bed rest and avoiding weight bearing on the affected side, for minor, non-displaced fractures.
• Surgical treatment, which is often required for displaced fractures to realign and stabilize the bones. This can involve the use of screws, plates, or other fixation devices.
• Rehabilitation, including physical therapy, is crucial for regaining strength and mobility after the injury has healed.

Complications

Complications from acetabular fractures can include:

• Arthritis developing in the hip joint, due to the damage to the cartilage.
• Avascular necrosis (AVN), where the blood supply to the femoral head is compromised, leading to bone death.
• Nerve damage, particularly to the sciatic nerve, which can result in numbness or weakness in the leg.

Prevention

Preventing acetabular fractures primarily involves minimizing the risk of high-energy trauma. This can include:

• Using seat belts and airbags in vehicles.
• Using appropriate safety gear when engaging in activities at heights.
• Creating safer environments to reduce the risk of falls, especially in older adults.