Acetabular Fracture Diagnosis & Treatment
Acetabular fractures (hip fractures) occur in the area where the pelvis meets the head of the femur, known as the “hip socket.” The acetabulum is actually the “socket” in the “ball-and-socket hip joint.”
Although not very common, these complex fractures are usually caused by direct trauma (high falls, auto accidents) to the pelvis and/or femur (thigh bone). Elderly patients may suffer these fractures due to weakened bones. Patients are often unable to walk on the damaged limb(s), with any hip movements leading to pain and muscle spasms.
An acetabular fracture can be successfully treated with surgery. Today, the orthopaedic surgeons at the Florida Hospital Orthopaedic Institute Fracture Care Center (FCC), regularly diagnose and treat acetabular fractures or hip fractures minimally invasively, using their experience and knowledge to further innovations in this area of orthopaedics.
If an acetabular fracture, or any type of hip fracture, is suspected, the FCC staff will first perform diagnostic exams. Specifically, pelvic X-rays and CAT scans will be given. Once confirmed, the surgical team determines the best course of treatment. This may depend on such factors as hip stability and the level of cartilage displacement.
Regardless of the body part, whether for the hip or calcaneus (heel), non-surgical treatment options may be provided for those without displaced/dislocated fractures, or those unable to undergo surgery. Typically, realignments are performed through manipulation. Often, elderly patients don’t undergo surgery.
If acetabular fracture surgery is required, the goals are to realign and stabilize the patient’s displaced joint surfaces. Besides enabling patients to avoid extended bed rest and traction, these procedures offer three benefits:
- The area’s cartilage surface is properly aligned
- Bone and other debris is removed from within the hip joint
- The hip’s stability is restored
At the Fracture Care Center, our surgeons may perform an “open reduction,” in which an incision is made to directly manipulate the bone. Or, they may perform a “closed reduction,” which doesn’t require incisions. Both procedures require fixations once realignment is achieved; this may utilize wires, pins, screws, and plates, to properly secure the bones during healing. Depending on the fracture’s severity, multiple procedures may be required.
For an acetabular fracture, especially those with displaced joints, an Open Reduction with Internal Fixation (ORIF) procedure may be necessary. This involves precise realignment or reductions of damaged bones with strong securing in place. As a result, future displacement is avoided and healing begins as quickly as possible.
These procedures are very successful, with research suggesting that 80-85% of patients should expect “good” to “excellent” post-surgical recoveries. We encourage you to submit an online appointment.
John: Back in the Race
John, an active tri-athlete, was distracted while cycling one-day and drove his bike off the road. He landed directly on his hip sustaining a serious acetabular (hip socket) fracture. John was originally told by physicians he would have trouble walking, and his athletic activities as a tri-athlete were over.
John was referred to Dr. Cole by surgeons who were familiar with the fact that Dr. Cole was well known as one of the first surgeons to develop a minimally invasive approach to treating acetabular (hip socket) fractures. Dr. Cole published a paper on this approach referred to as the “Stoppa Approach” in 1994, after his minimally invasive procedure was developed. Dr. Cole has many years of experience with this approach. To John, having a surgeon with extensive experience in the treatment of acetabular (hip socket) fractures meant walking and possibly competing again. Because of John’s complex injury, his surgery involved this minimally invasive anterior approach as well as a posterior approach.
Today, John is recovered and competing again in triathlons.