T Acetabular Frx               



- 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.



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

Last updated by Data Trace Staff on Tuesday, September 12, 2017 7:22 am