Fractures of the acetabulum - surgical treatment and complications

Abstract

Acetabular fractures represent severe injuries that mostly occur in car accidents, or after falling from greater heights, most often in the working male population. Acetabular fractures are present in our clinical practice and their treatment requires good education and surgical training. Surgical experience is one of the prerequisites for achieving good treatment results, since these fractures are accompanied by numerous complications. In order to acquire knowledge and skills in this field of surgery, it is necessary to have a national center for education at one of the medical faculties in Serbia. All dislocated acetabular fractures (≥ 2 mm) require early surgery, anatomical reduction, and stable internal fixation of acetabular fracture. Acetabular fracture-dislocation requires urgent reduction of the dislocated femoral head. The anatomic reduction of the fracture is related to the time of definitive bone fixation of the fracture. Fourteen days after the fracture, anatomic reduction is more difficult to achieve. In addition to the factors that positively affect the results of treatment, there are negative factors as well, which result in poor outcomes. They are directly correlated to the initial trauma that occurs at the time of injury. Fracture comminution, large dislocation (> 20 mm), injury of the femoral head, posterior dislocation of the hip, impaction, traumatic or iatrogenic sciatic nerve palsy – these are all factors that negatively affect the outcome and are responsible for complications, as opposed to positive factors.

Keywords

• acetabulum
• fractures
• surgical treatment
• complications