- See:
Transverse Fractures of the Acetabulum: 
- Discussion:
- compared to other types of acetabular frx, the T Shaped - Posterior Wall Frx may have the highest
prevalence of poor clinical results;
- T shaped fractures which are known to be especially difficult, include those w/ a transtectal component,
those w/ wide separation of the verticle fracture line, and those w/ pubic rami fracture;
- Approach:
- frx is approached using
Kocher Langenbock approach w/ pt prone;
- often a
trochanteric slide osteotomy will be required for additional exposure;
- if a difficult reduction is expected, it is sometimes preferable to use the extended
iliofemoral
or triradiate incision;
- Reduction and Fixation of Anterior Column;
- distraction of
posterior column frx line, allows visualization frx of
anterior column on acetabular articular surface;
- anterior column is reduced w/ bone hook & pointed reduction clamps;
-
anterior column is manipulated thru
sciatic notch, or thru joint;
- fixation utilizes lag screws placed from posterior to anterior direction;
- if these maneuvers do not produce adequate
reduction, subsequent
ilioinguinal approach is required;
- Reduction of Posterior Column:
-
posterior column is reduced and stabilize;
- frx may be approached & reduced as posterior column injury;
The acetabular T-type fracture. A biomechanical evaluation of internal fixation.
Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results.
Reconstruction of the pelvic brim and its role in the reduction accuracy of displaced T-shaped acetabular fracture.
Reconstruction of the pelvic brim and its role in the reduction accuracy of displaced T-shaped acetabular fracture.
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