ICD-9 Classification / Treatment Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis Anatomy Complications Clinical Evaluation Follow-up Care Xray / Diagnositc Tests Review References
A- initial encounter for closed fracture
B- initial encounter for open fracture
D- subsequent encounter for fracture with routine healing
G- subsequent encounter for fracture with delayed healing
K- subsequent encounter for fracture with nonunion
- 808.0 (closed)
- Generally result from high energey trauma.
- See Hip / Pelvis anatomy.
- ATLSresuscitation. These can be high enegery injuries, assessment should begin with the A,B,C's.
- Document neurovascular exam before and after any treatment, especially reduction of dislocated hip.
- A/P pelvis, and Judet views (45° iliac and oburator oblique views.)
- CT scan: assess for posterior pelvic ring injury, femoral head fracture, intra-articular fragments, impaction.
- Posterior Wall: posterior wall fragments <1/3 of the surface are generally stable. Fx >50% of surface are unstable. Intermiately sized fxs should undergo fluoroscopic EUA to determine stability.
- Letournel Classification
- Hip dislocation: should be reduced as soon as medically possible. Consider post-reduction traction, especially for medially displaced dislocations. Post-reduction xrays documenting reduction are required.
- Pelvic ring injury
- Femoral head fracture
- Femoral neck fracture
- Femoral shaft fracture
- PCL tear
- Knee dislocation
- Neurologic injury
- Poor wound healing
- Chronic Osteomyelitis
- Painful hardware
- Loss of reduction
- Limb length discrepancy
- Sitting imbalance
- Gait disturbance
- DVT / PE (Borer DS, JOT 2005;19:92).
- Heterotopic ossification: Extensile (extended iliofemoral or triradiate) approaches are associated with the highest incidence of ectopic bone formation, whereas the ilioinguinal approach is rarely associated with this complication. Rates up to 45-100% are reported. The HO is most extensive when no prophylaxis is provided using extended approaches. Routine prophylaxis consists of either 1) Indomethacin 25 mg tid for 4-6 weeks, beginning POD #1 or 2) Low dose irradiation 1000 rads in divided doses or 700 rads single dose, begun before POD #4.Surgical excision is only considered when the HO severely reduces hip mobility. Preop CT scan is recommended.
- Outcome is dependent on quality of reduction.
- Hip Outcomes assessment.
- Rockwood and Greens
- Epstein HC, Wiss DA, Cozen L: Posterior fracture dislocation of the hip with fractures of the femoral head. Clin Orthop 1985;201:9-17
- Poka A, Libby EP: Indications and techniques for external fixation of the pelvis. Clin Orthop 1996329:54-59.
- Olson SA, Pollak AN: Assessment of pelvic ring stability after injury: Indications for surgical stabilization. Clin Orthop 1996329:15-27.
- Ghanayem AJ, Stover MD, Goldstein JA, et al: Emergent treatment of pelvic fractures: Comparison of methods for stabilization. Clin Orthop 1995.318:75-8O.
- Matta JM: Fracture of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. JBJS 1996; 78A: 1632-1645
You are here
Acetabular Fracture S32.409A 808.0
The information on this website is intended for orthopaedic surgeons. It is not intended for the general public. The information on this website may not be complete or accurate. The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician. See Site Terms / Full Disclaimer.