What is an Acetabular Fracture?

An acetabular fracture is defined as a broken hip joint socket. This usually occurs as a result of severe trauma to the area, or osteoporosis may contribute to it if the patient is elderly. After using imaging tests to determine the extent of the damage, the doctor will decide whether surgery is necessary. In some cases, an acetabular fracture may be allowed to heal without surgery, but in surgical cases, the surgeon will realign the bones and remove any loose fragments.

The acetabulum is a component of the pelvis that forms the socket of the hip joint at the end of the thigh bone. This is a ball and socket joint, in which the ball is free to rotate and provide a greater range of motion. When a fracture occurs in this area, it is usually the ball of the joint that is broken. An acetabular fracture means that the socket itself has broken. People who suffer from this type of fracture will experience pain in the groin and leg, particularly when they place weight on the leg.

Young patients who develop an acetabular fracture have typically been involved in an automobile accident or have suffered a high-impact sports injury. It is possible for elderly patients with bones weakened by osteoporosis to have this condition from a low-impact fall or other trauma. When the doctor suspects an acetabular fracture, he will order imaging tests, such as x-rays. This allows him to evaluate the extent of the damage and determine whether the ball has been displaced from the socket.

In some cases, the ball remains within the socket, the joint is still stable, and the cartilage is properly aligned. The doctor may recommend allowing the acetabular fracture to heal on its own, particularly if the patient is elderly. Patients will be unable to place weight on the affected leg for up to three months while the bone heals. They may touch the affected foot to the ground, so long as the weight is firmly on the other foot. Patients will use either crutches or a wheelchair during this time.

Those who require surgery are urged to undergo the procedure within the first week of injury. Often, general anesthesia is used for an acetabular fracture repair. After making an incision, the surgeon will cleanse the area, remove any loose fragments or debris, and realign the bone. Plates and screws are typically used to stabilize the area and hold the bones in place while they heal.

Following the surgery, the patient will be encouraged to engage in physical therapy as soon as possible to reduce the chance of developing blood clots. They will likely be given blood thinners and pain medication. Patients will need to restrict activities for the first six weeks, followed by more intensive physical therapy. They will use crutches, a walker, or a wheelchair until the fracture is healed.

Before undergoing surgery for an acetabular fracture, patients should be aware of possible risks. Infection and pneumonia have been reported, along with constipation and disrupted blood flow. There are also risks associated with the fracture itself, regardless of whether the patient undergoes surgery. Blood clots are a particular concern for this type of injury. Long-term complications can include hip arthritis and excessive bone formation, called heterotopic bone formation.