Fractures of the Acetabulum
The acetabulum is often referred to as the socket part of the hip joint. It is the cup part of the pelvis that wraps around the ball or head portion of the femur to create the hip joint. Fractures of the acetabulum are very complex and severe injuries that occur after high energy trauma such as fall from a height or a motor vehicle crash. These injuries have significant relevance both initially and long term. Many patients with a fracture of the acetabulum also have other major trauma including injuries to the head, chest and abdomen. The orthopaedic trauma surgeon plays a critical role in the initial management of these injuries and the initial stabilization of the patient. The doctors at Sonoran Orthopaedic Trauma Surgeons have extensive experience with critically injured patients.
It has clearly been demonstrated that accuracy of reduction (the quality of the repair of the actual joint surface) is predictive of the patient's long term outcome. Acetabular fracture surgery is very complex with long arduous dissections and difficult bone work. These procedures should only be done by experienced surgeons who do several a year and have specialized training in pelvic fracture surgery. Dr. Rhorer and Dr. Ortega trained with some of the world's leading pelvic fracture surgeons, and they continue to remain up to date on the latest techniques in acetabular fracture management.
Perhaps the most important facet of fractures of the acetabulum to understand is the many complications of both the injury and the surgery to fix them. Patients with acetabular fractures have a high risk of developing arthritis after the injury. This may become so severe that a total hip replacement is necessary. A portion of patients may have nerve or arterial injuries that cause weakness, numbness and pain. We identify these associated injuries as soon as possible and use a multidisciplinary approach to treat these difficult problems. Many patients with these injuries are at risk for other medical problems such as infection or blood clots in the veins of the pelvis and legs. Furthermore, the acetabulum is situated in one of the most eloquent parts of the body. There are numerous large blood vessels, nerves and visceral structures within millimeters of the operative site. Therefore, the importance of an experienced pelvic fracture surgeon can not be underscored enough. Even the hands of the most skilled orthopaedic trauma surgeons, fractures of the pelvis can be complicated by severe bleeding and neurologic injury.
Pelvic and acetabular fractures can be fixed up to 3-4 weeks after the initial injury. It is easier to fix them in the first ten days, but stabilization of a multiply injured patient is of utmost importance. If you or a family member are at another facility and wish to be transferred to the care of Sonoran Orthopaedic Trauma Surgeons, please have your surgeon call our office to arrange a transfer.
