ACETABULAR FRACTURES

Document Sample
ACETABULAR  FRACTURES Powered By Docstoc
					ACETABULAR FRACTURES
Anatomy
 Radiological evaluation
 Plain x-ray
   A.p
     1 Iliopectineal line
     2 Ilioischial line.
      3 Radiographic teardrop
     4 Roof of acetabulum.
     5 Edge of anterior lip of
      acetabulum.
     6 Edge of posterior lip of
      acetabulum.
   Judet views
CT
  Classification (Letournel & Judet )
 Simple:
     A: Post. wall fr.
     B: Post. column fr.
     C: Ant. wall fr.
     D: Ant. column fr.
     E: Transverse fr.
 Associated:
   F: Post. Col. + post. wall fr.
   G: Trans. + post. wall fr.
   H: T-shaped fr.
   I: Ant. Col.+ post.
    hemitransverse fr.
   J: Complete both-column
    fr.
Treatment
Nonoperative:
  Nondisplaced and Minimally Displaced Fractures
  Fractures with Significant Displacement but in Which
   the Region of the Joint Involved Is Judged to Be
   Unimportant Prognostically
  Secondary Congruence in Displaced Both-Column
   Fractures
  Medical Contraindications to Surgery
  Local Soft-Tissue Problems, such as Infection, Wounds,
   and Soft-Tissue Lesions from Blunt Trauma
  Elderly Patients with Osteoporotic Bone in Whom
   Open Reduction May Not Be Feasible
Operative:
  Displaced fr > 2mm
  posterior wall fractures with more than 50%
   involvement of the articular surface of the
   posterior wall or clinical instability with hip
   flexion to 90 degrees.
  Incarcerated Fragments in the acetabulum after
   closed reduction of a hip dislocation
  Prevention of nonunion and retention of sufficient
   bone stock for later reconstructive surgery
Complications
 Posttraumatic arthritis
 Osteonecrosis
 Infections
 Sciatic nerve palsies
 Heterotopic ossification
 Thromboembolism

				
DOCUMENT INFO
Shared By:
Tags:
Stats:
views:0
posted:7/24/2013
language:Latin
pages:14