Acetabular Fractures

The hip joint is a ball and socket configuration, with the femur inserting into the “socket” of the pelvis. An acetabular fracture is one that happens in the socket portion of the joint, and are much less common than those that involve the femoral head, or “ball” of the joint.

Most acetabular fractures occur as a result of a high-energy event such as a car accident, but in a small number of cases, they have happened following a low-energy event like a fall from standing.

Anatomy

One of the largest joints in the body, the hip is formed by the acetabulum which is part of the pelvis, and the femoral head which makes up the ball portion of the joint. The bone surfaces are covered in cartilage to allow for smooth movement, and bands of tissue called ligaments provide function and stability to the joint, allowing for movement without the femur falling out of the socket.

Description

Acetabular fractures can vary in size, location, and severity.  The bone may break straight across the acetabulum, or in some cases, the bone can shatter. When the acetabulum is fractured, the femoral head may not fit firmly in the socket and can result in damage to the cartilage surface of both bones.

Severity

 The severity of the injury depends on several factors, including:

• The number and size of the fractures
• The amount of displacement of each fractured piece
• Damage inflicted to the cartilage surfaces of both the acetabulum and head of the femur
• Damage to surrounding soft tissues, like muscle, tendons, nerves, and skin

Symptoms

An acetabular fracture is almost always painful due to the large size of the joint and how much load that area bears on a daily basis. The pain will be worsened under movement, and if a nerve was damaged during the injury, there might be numbness, weakness, or tingling down the leg.

Treatment

Several things will be considered when planning an appropriate treatment, including:

• The pattern of the fracture
• Amount of displacement in the bones
• Overall health

Nonsurgical Treatment

Nonsurgical treatment may be recommended for fractures in which the bones are not displaced. It is also the preferred option for those who are at a higher risk for surgical complication – those with severe osteoporosis or heart disease for example.

Nonsurgical treatments include:

• Walking aids such as crutches to avoid putting weight on the affected leg
• Positioning pads may be used if your doctor is concerned about possible joint instability during healing
• Medications may be used to help manage pain, and a blood thinner may be used to reduce the risk of blood clots forming

Surgical Treatment

The majority of acetabular fractures are treated with surgery. The main objective of surgical treatment is to restore a smooth hip cartilage surface for pain-free movement in the future.

During surgery, the normal anatomy of the hip joint will be restored, refitting the femoral head into the hip socket.

Typically, surgery is not carried out right away. Your surgeon may delay the procedure for a few days to make sure your overall condition is stable enough to undergo surgery.

Outcomes

Acetabular fractures take a long time to fully heal, with most patients fully recovering in 9 to 12 months. Outcomes vary by patient, depending on factors like:

• Fracture severity and pattern
• Any other injuries associated with the trauma
• Age and bone quality
• General health, including smoking status. Data shows that smoking can slow down bone healing and increase the likelihood of complication

If you’re suffering from an acetabular fracture, request an appointment online or at 904-825-0540 with our team of orthopaedic specialists today. We’re here to help you get back to doing what you love most.