Incidence of the Acetabuar Fracture
In AL-Thawra Modern general hospital
During 2009 –Sana'a-Yemen
‫د‪.‬سعيد عبد هللا بامشموس‬
‫د‪ .‬صالح مقبل الفيصلي‬
Ant. View of
ACETABULAM
Post. View of
ACETABULAM
.
Callisen in 1788
start to said and to have
reported the case of an
acetabular fracture
During 2009
70 patients
with
acetabular fractures
Gender distribution of 70 patients
with acetabular fractures
14(20%)
56 cases(80%)
The main cause of fracture is
DISLUCATION OF THE HIP
● this injury is due to massive force
transmitted along the femoral shaft, e.g.
road traffic accidents or a back injury in
someone kneeling.
distribution of 70 patients with
acetabular fracture according to
mechanism of injury
MECHANISM OF
TRAUMA
GENDER FEMALE
T
%
RTA
40
57%
GUN SHOT
5
7%
FALLING
21
30%
OTHER
4
6%
TOTAL
70
100.00%
Type of Dislocation depends on
position :
I. Anterior dislocation of hip
7-10% OF DIS
NON FRACTURE
OF ACETABULAM
II. Posterior dislocation
Most common type of
dislocation.
Posterior rim is usually
fractured
Associated sciatic nerve
injury in 10%
flexed,
shortened,
adducted and
internally rotated
III. CENTRAL dislocation
Direct impact to
the aspect
of the hip
through
the acetabulum.
This is a fracture -dislocation.
Distribution of the acetabualr
fracture by age group and gender
AGE
GROUPS
GENDER
TOTAL
M
F
N
%
19-20
7
3
10
7%
21-30
36
7
43
30.1%
31-40
11
1
12
8.4%
41-50
4
1
3
2.1%
51-60
9
2
9
6.3%
TOTAL
56
14
70
100.00%
I. AP View
pelvis
ACETABLUM
FEMORAL HEAD
FEMORAL NECK
GREATER
TROCHANTER
FOVEA CAPITIS
LESSER
TROCHANTER
CORTICAL BONE
MEDULLARY BONE
II. JUDET view
OBTURATOR
(Internal
oblique view)
III . JUDET view
Iliac (exteternal
oblique view)
WE CAN
DIAGNOSED
THE FRACTURE
IN ONE OF 3 VIEW
CT is a very useful to assessment
and planning of surgery.
70 patients with acetabular fracture
accoding to associated injures
TOTAL
ASSOCIATED TRAUMA
N
%
MULTIBLE TRAUMA
27
38%
ISOLATED ACETABULAR
43
62%
70
100%
FRACTURE
TOTAL
Distrubiton of acetabular fracture according
to departement of intial admission
INTENSIVE CARE UNIT
GENDER
M
F
5
2
TOTAL
T
%
7
10%
SURGICAL DEP.
7
2
9
12.8%
ORTHOPEDIC DEP.
35
8
43
61.4%
NEUROSURGICAL DEP.
4
1
5
7%
UROLOGY DEP.
5
1
6
8.5%
56
14
70
100%
DEPARTMENT
TOTAL
associated injury
distribution of complication releated to the
associated injury in 27 patients:
ASSOCIATED INJURIE
N
%
LIMBS
6
22.2
VASCULAR
3
16.2
NEUROLOGY
2
11.6
UROLOGY
9
33.3
ABOMINAL
3
4.6
THORACIC
4
2.3
TOTAL
27
38%
We used Letournel ANATOMICAL
system classification
TYPE OF
NO
CLASSIFICATION
SIMPLE FRACTURE TYPE
%
posterior wall
20
28%
posterior column
3
4.2%
anterior wall
1
1.4%
anterior column
2
2.8%
transverse
7
10%
ASSOCIATED FRACTURE TYPE
posterior column +posterior wall
1
1.4%
transverse +posterior wall
11
15.7%
T- shape
5
7%
anterior column or wall +
posteriorhemitransverase
8
11.4%
both column
12
17%
Treatment
I. Closed reduction
( to reduce pain )
II. SURGICAL
Closed reduction
Four methods of closed
reduction :
1.
2. Allis traction
3.
4 .Classical
watson`s– jones method :
Skin Traction
Skeletal traction
II. SURGICAL treatment
should be considered for:
. all displaced fractures of the
acetabulum.
. that do not meet the criteria for
nonoperative therapy.
Orthopaedic Surgeon Can
Get You Back Into The Game