Acetabulum fracture
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The acetabulum is the part of the hip joint that is in the pelvic area, it is the spherical part that offers space for the femoral head and allows movement. Fracture of the acetabulum is not very common, it is usually caused by high-impact movements such as car accidents or in elderly patients with osteoporosis due to falls.
Acetabular fractures can occur within the cavity or the socket or in the heart of the body.
In some cases, the fracture does not allow the femoral head to fit into the socket, which can cause long-term damage to the cartilage.
Acetabulum fracture treatment
As mentioned above, the acetabular fracture is caused by a high-energy impact that generally complicates the patient’s health with other injuries, to solve this doctors must act quickly, in an emergency, and stabilize the patient especially when there is a lot of blood loss.
To offer an effective treatment, the doctor must consider various aspects to plan the procedure, for example, the patient’s current situation, medical history or history, the patient’s age and especially the state of pregnancy of the fracture.
With this data, you can choose some of the following treatment options.
Conservative or non-surgical treatment
It is recommended for patients with non-displaced fractures and especially with comorbidities that complicate or make surgical intervention impossible, that is, a patient with an advanced age, complex medical history and with little chance of enduring surgery.
The treatment consists of the application of transskeletal traction with bed rest for a period of six weeks, then mobility with partial load is allowed in the affected area.
The patient may also be provided with a positioning device to help maintain a correct position of the joint, as well as some medications that help the patient’s well-being.
This treatment can lead to severe functional limitation of the joint as a result, so it is only applied in special cases.
Dr. Jose Felix Castillo can help you relieve your hip ailments
Surgical treatment or surgery for acetabulum fracture
It is important to mention that it is a complex injury, it is a challenge for orthopedic surgeons who must have experience to achieve an efficient result. During surgery, the aim is to reduce the displaced bone fragments to their regular position and apply metal plates and/or screws to fix these parts to their new position and hold them together so that they heal.
The approach is chosen according to the area of the fracture, it can be a frontal, posterior or lateral incision or a combination of two routes. After surgical treatment, the doctor will recommend a few days of absolute rest with the leg in traction to avoid further injury to the bone, and depending on the patient’s progress, fracture characteristics, and joint damage, a total hip replacement may be suggested.
Signs and symptoms of acetabulum fracture:
Most of the time the fracture is evident due to a strong impact, in older people it can be caused by a fall and the symptoms present as follows:
- Severe pain in the hip or groin.
- Inability to get up or walk
- Inability to bear weight on the leg on the affected side.
- Bruising and swelling around the hip.
- Obvious differences in the leg such as one shorter than the other or an outward twist on the side of the injured hip.
In order for doctors to diagnose the fracture and its pregnancy, they must first stabilize the emergency, if the patient arrives because of a serious accident that complicates other aspects of health, it must be stabilized.
A physical examination is then performed and if the symptoms of an acetabular fracture are verified, an imaging exam is requested to determine the level of pregnancy of the injury and proceed with treatment.
Physical therapy for acetabulum fracture
Physiotherapy exercises are ideal for regaining mobility in the fractured area after completing the rest of surgery. The orthopedic surgeon will define the appropriate time to try the exercises and make certain recommendations to begin with mobility.
Through physiotherapy the patient will be able to recover muscle strength and mobility, as a result the joint can be functional. Without appropriate exercises, the patient will run the risk of having muscle trophism and delaying or limiting their walking process.
Sequelae of acetabulum fracture
The greatest sequelae of this injury is the reduction of the patient’s independence due to lack of mobility. After a fracture like this, the patient may not be able to move, walk, or walk independently again.
In the most severe cases, of older adults with comorbidities and various injuries that must remain immobile for too long, other sequelae may occur such as:
- Urinary tract infections.
- Pneumonia.
- Loss of muscle mass.
- Blood clots in the legs with risk of affecting the lungs, brain and heart.
- Death.
Complications of Acetabular Fracture Surgery
Some of the possible complications after surgical treatment are:
- Infection of the area.
- Blood clots.
- Sciatic nerve injuries.
- Post-traumatic arthritis.