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Acetabular pelvic fractures
From WikEM
(Redirected from Acetabular pelvic fracture)
Contents
Background
- Fractures usually occur when head of femur forced into acetabulum
- Obvious when displaced, subtle non-displaced
Anatomy
- Anterior column-anterior acetabulum to pubic ramus
- Posterior column- posterior acetabulum to ischial ramus
- Anterior and posterior columns merge to form acetabular dome= weight bearing portion
- Fractures involving acetabular dome require operative fixation
Clinical Features
- Pelvic pain after trauma (low energy for elderly, high energy for young)
Differential Diagnosis
Hip pain
- Femur fracture
- Hip dislocation
- Hip bursitis
- Psoas abscess
- Piriformis syndrome
- Meralgia paresthetica
- Septic Arthritis (Hip)
- Obturator nerve entrapment
- Pelvic fractures
- Acetabular pelvic fractures
- Open book pelvic fracture
- Straddle pelvic fracture
- Pelvic avulsion fracture
- Avascular necrosis of hip
Evaluation
Radiographically
- Consider obtaining AP, Judet, and inlet/outlet films
- Iliopubic line extends from ilium to superior pubic ramus
- Ilioischial line- extends from ilium to ischial ramus forming radiographic teardrop, "U" shaped, on AP pelvis
- Quadrilateral plate forms medial wall of acetabulum
Fractures Types
- Anterior column
- Posterior column
- Transverse
- T or Y-shaped
- Posterior rim
- Anterior Wall
Management
- Early ortho consultation and hospital admission is indicated for all
Disposition
- Admission
