BY BLUE TEAM

By Dr Kabiru Salisu NOHD

 INTRODUCTION  HISTORY  EPIDEMIIOLOGY  AETIOLOGY  PATHOPHYSIOLOGY  SURGICAL ANATOMY  CLASSIFICATION

 Acetabular fracture(AF), is the fracture of the socket of hip joint  is common in young adult  It is one of the most challenging fractures for the orthopaedic surgeon to understand and successfully treat

 These fractures are often associated with other life- threatening injuries Orthopaedic - Extremity injury (36%) - Nerve palsy (13%) - Spine injury (4%) Systemic injuries - head injury (19%) - Chest injury (18%) - Abdominal injury (8%) - Genitourinary injury (6%

 Acetabular fracture usually result from high energy injury  Anatomic reduction and stable fixation of the fracture, is the treatment goal in these difficult fractures

 Fractures of the acetabulum were treated nonoperatively until the middle of the 20th century  The Judets & Emile Letournel study was responsible for popularizing the surgical management

 With advances in imaging technologies, performing acetabular fracture surgery through smaller incisions is now possible

 The exact incidence of acetabular fractures in various parts of the world is not known.  Studies at level I trauma centers have shown an admission rate for pelvic and acetabular fractures of %

 Acetabulum fractures usually occur as a result of high-velocity trauma, such as; - Motor vehicular accidents or - Falls from heights

 AF occur as a result of the force exerted through the head of the femur to the acetabulum.  The femoral head acts like a hammer and is the last link in the chain of forces transmitted from the greater trochanter, knee, or foot to the acetabulum.  The position of the femur at the time of impact and the direction of the force determine the type and displacement of the fracture

◦ Inverted “Y” two column concept (1966) ◦ Columns are connected to the SI joint by a thick area of bone above the greater sciatic notch known as the sciatic buttress

 Several classifications for AF do exist, all the classifications are base on the anatomy described by Judets and letournel

 This is the most widely accepted classification  This system divides fractures of the acetabulum into; - Five simple (elementary) - Five complex (associated)

This is a modification of judet & letournel classification Type A- pertial articular involving only one column A1- Posterior column fracture A2-posterior wall fracture A3- Anterior column and wall

 Type B- Partial articular, involving transverse component B1 - pure transverse B2 - T- shaped B3 - Anterior column and posterior hemitransverse

 Type c- complete articular both columns C1- High variety extending to iliac crest C2- Low variety extending to the anterior border of the ilium C3 – Extention into the sacroiliac joint