Focus on acetabular fractures

Excerpt

Displaced acetabular fractures have always been a major challenge for trauma surgeons. Conservative management includes immobilization in bed during several weeks and regularly results in a moderate functional outcome. For surgical treatment various surgical approaches are established [1]. A skilled selection of the appropriate surgical approach is essential as large incisions used to reach the innominate bone and acetabulum can cause severe surgical complications. Open reduction and internal fixation (ORIF) is the method of choice in patients below the age of 60. After adequate surgery, conversion to a total hip arthroplasty following posttraumatic osteoarthritis can be avoided in up to 80% of patients [2]. In patients above the age of 60, there is an ongoing discussion on the best method of treatment. ORIF is only accepted, when the joint is good reconstructible and in absence of preexisting osteoarthritis [3, 4]. In other cases, acute total hip arthroplasty is the method of choice with or without ORIF (the “Combined Hip Procedure”). …