Pelviss Acetabulum Fracture

🦴 Pelvis Acetabulum Fracture
🔹 What It Is
. A fracture involving the acetabulum (the cup-shaped cavity in the pelvis).
. Usually occurs due to high-energy trauma like road traffic accidents or falls from height.
. Can be isolated or associated with other pelvic fractures, hip dislocation, or injuries to abdominal organs/nerves/vessels.

🔹 Causes
. Road traffic accidents 🚗
. Falls from height 🏗️
. Sports injuries (rare, usually with high force)
. In elderly, even a minor fall (due to osteoporosis)

🔹 Symptoms
. Severe hip/pelvis pain
. Inability to walk or bear weight
. Swelling, bruising, or deformity around the hip
. Shortening/rotation of leg (if hip is dislocated)
. Sometimes associated with shock, bleeding, or nerve injury (sciatic nerve involvement)

🔹 Diagnosis
. X-ray pelvis (AP view + Judet views for acetabulum)
. CT scan → gold standard, helps classify the fracture
. MRI if soft tissue or cartilage damage suspected

🔹 Classification
Two main systems:
. Letournel & Judet classification → most widely used (elementary & associated fracture types).
. AO/OTA classification

🔹 Treatment
1. Non-Surgical (Conservative)
. For non-displaced fractures, elderly patients, or those unfit for surgery
. Bed rest, traction, pain management
. Gradual physiotherapy and mobilization

2. Surgical
. Indications:
. Displaced fractures
. Hip instability
. Intra-articular step/gap (>2 mm)
. Associated hip dislocation
Procedures:
. ORIF (Open Reduction and Internal Fixation) with plates/screws
. Total Hip Replacement (THR) (in elderly with severe comminution/arthritis)

🔹 Complications
. Post-traumatic arthritis (most common)
. Avascular necrosis of femoral head
. Sciatic nerve injury
. Chronic hip pain & stiffness
. Limb length discrepancy

🔹 Recovery
. Bone healing: ~8–12 weeks
. Non-weight bearing for 6–12 weeks → then gradual partial weight bearing
. Full recovery may take 6–12 months depending on severity
. Physiotherapy is crucial for hip mobility & strength