Arthroscopic Reduction and Internal Fixation of a Rim Fracture

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Arthroscopic Reduction and Internal Fixation of a Rim Fracture Raul Torres-Eguía, M.D., Jesús Más Martínez, M.D., Javier Sanz-Reig, M.D. Arthroscopy Techniques Volume 6, Issue 6, Pages e2155-e2160 (December 2017) DOI: 10.1016/j.eats.2017.08.010 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Radiographic anteroposterior pelvis view of the bilateral hips demonstrating the presence of a rim fracture on a left hip (white arrow). Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 In the left hip, the center-edge angle (CEA) has been measured incorporating the fragment (52°) and taking into consideration complete removal of the fragment (24°). Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Radiographic Dunn view on a left hip revealed a rim fracture (white arrow) and cam lesion (gray arrow). Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Three-dimensional reconstructions on the left hemipelvis showed a large superior rim fracture (white arrow). Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Left hip sagittal T2-weighted magnetic resonance imaging of the area of the rim fragment (white arrow). Note the relation of the labrum and the fragment. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic left hip view from the anterolateral portal of the bone fragment after partial resection (white arrow). Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 7 Arthroscopic left hip view from the anterolateral portal. A 1.6-mm Kirschner wire is passed through the distal anterior portal and guided in the central portion of the bone fragment. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 8 Arthroscopic left hip view from the anterolateral portal. Drill hole is performed with a 3.2-mm drill bit passed through the distal anterior portal. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 9 Arthroscopic left view from the anterolateral portal. Screw sizing is made with a second Kirschner wire introduced through the distal anterior portal. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 10 Arthroscopic left view from the anterolateral portal. Bone fragment is fixed with a 4.5-mm unicortical cannulated screw with a washer introduced through the distal anterior portal. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 11 Radiographic anteroposterior pelvis view of the bilateral hips at 1-year follow-up showed partial resection of the rim fracture and internal fixation with a cannulated screw with a washer. The rim fracture had healed. The joint remained congruent without joint space narrowing. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 12 In the left hip, the center-edge angle (CEA) had decreased from 52° to 34° postoperatively. Arthroscopy Techniques 2017 6, e2155-e2160DOI: (10.1016/j.eats.2017.08.010) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions