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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Fractures of the Acetabulum   


- See:
          - Pelvic Frx
          - Radiographs
          - Work Up and Treatment

         - Anterior Column Frx
         - Anterior Wall Fractures
         - Both Column Frx
         - Central Acebular Fracture Dislocations
         - Classification and Column Theory
         - Displaced Dome Fractures
         - Heterotopic Ossification
         - Hip Frx
         - Fracture Dislocations of the Hip
         - Judet View
         - Iliofemoral Approach to the Acetabulum
         - Ilioinguinal Approach to the Acetabulum
         - Pediatric Acetabular Fractures
         - Posterolateral Approach: (Kocher Langenbach)
         - Posterior Column Frx
         - Posterior Wall Fractures
         - Radiology of the Acetabulum
         - Reduction
         - T Shaped Fractures
         - Total Hip Replacement for Acetabular Fractures
         - Transverse Fractures of the Acetabulum
         - Triradiate Approach
         - Two-Column Fractures


- Classification and Column Theory
    - elementary frx:
            - account for about 20% of acetabular frx;
            - anterior wall
            - anterior column:
                   - bony strut running from ASIS to superior pubic ramus, & includes anterior wall;
                   - iliopectineal line is involved;
            - transverse frx
                   - involve both anterior & posterior acetabulum: dividing the innominate bone into superior segment containing acetabular roof & intact ilium,
                            & inferior segment consisting of single ischiopubic fragment;
            - posterior wall:
                   - posterior wall frxs always involve posterior articular surfaces, often accompanied by a portion of retroacetabular surface and sometimes entire surface;
            - posterior column:
                   - bony strut running from PSIS to inferior pubic ramus, & includes posterior wall;
                   - involves not only the posterior articular surfaces, but also the ilioischial line;
    - associated frx types:
            - account for about 80% of acetabular frx;
            - are composed of two or more of the elementary fracture patterns;
            - many assoc frx types, esp two-column frx, require more extensive exposures than are achieved by either ilioinguinal or posterolateral approach alone;
            - five patterns include:
                    - posterior column + posterior wall fractures:
                    - transverse + posterior wall frx;
                    - anterior column + anterior wall plus associated w/ posterior hemitransverse fractures;
                    - T-shaped fracture;
                    - both column frx: this is the most common frx type (about 35% of acetabular frx);

- References for Surgical Exposure:
         - A modified extensile exposure for the treatment of complex or malunited acetabular fractures.
         - Operative treatment of complex acetabular fractures. Combined anterior and posterior exposures during the same procedure.
         - Non-extensile surgical approaches for two-column acetabular fractures.
         - The triradiate incision for acetabular fractures. A prospective study of 23 cases.
         - Management of complex acetabular fractures through single nonextensile exposures
         - Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results.
         - Surgical revision of malreduced acetabular fractures.
         - Surgical dislocation of the femoral head for joint debridement and accurate reduction of fractures of the acetabulum.
         - The use of trochanteric slide osteotomy in the treatment of displaced acetabular fractures.
         - Osteotomy of the Trochanter in Open Reduction and Internal Fixation of Acetabular Fractures.
         - Modified Ollier Transtrochanteric Approach for the Treatment of Acetabular Fractures

- see synthes technique guide



Fractures of the Acetabulum: accuracy of reduction and clinical results in patients managed operatively with in three weeks after the injury.

Fractures of the acetabulum. Early results of a prospective study.

Displaced acetabular fractures

Complex acetabular fractures.

Stabilization of acetabular fractures in elderly patients.

Results in patients with craniocerebral trauma and an operatively managed acetabular fracture.

Results of 75 consecutive patients with an acetabular fracture.

Fractures of the acetabulum. A study of a series of 75 cases. 1961 

A prospective study of surgically treated acetabular fractures.

Open reduction and internal fixation of fractures of the acetabulum. Results in 163 fractures.

Delayed reconstruction of acetabular fractures 21-120 days following injury.

Fractures of the Acetabulum.  

Tips & Techniques New Tool for Applying Traction During Open Reduction and Internal Fixation of Acetabular Fractures




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, July 21, 2013 9:22 pm