The acetabular wall fracture: causes, treatment, consequences, and recovery, disability

Fracture of the acetabulum: treatment and effects of trauma

Hip performs in the human body a huge role, it is one of the most important joints, as well as experiencing daily heavy load. It is thanks to him people can walk, because he is involved in all stages of the movement.

Fractures of the acetabulum, parts of the joint, is a dangerous condition which, in the absence of proper treatment can lead to serious consequences, disability, and can affect your quality of life.

Trauma in the area of the acetabulum is a violation of the integral structure of the pelvic bone at the site where the femoral head abuts the pelvis.

This disturbed the structural integrity of the articular fossa. This is one of the most difficult common injuries. It accounts for about 15-16 % of all cases of damage to the hip joint.

Anatomical and physiological features

Acetabulum is spherical in shape, deep inside the joint, the interior is lined with articular cartilage.

Banded acetabular lip, it is formed by the merging of sciatic, iliac and pubic bone. The cavity consists of the front wall, rear wall, front pillars, rear pillars and the roof.

The edges of the basin is within the cartilage, and the joint covered with a capsule. Inside cavity is lined with synovial membrane, which produces joint fluid, providing «lubrication» of the joint.

On all sides it is covered by muscles and ligaments. It is due to this complex structure is secured by fastening the head of the femur to the bones of the pelvis.

With the hip joint of the person can raise and lower the leg, make circular movements of the thigh move the thigh forward and backward. Bone columns give the depression of strength.

Classification of fractures

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Injuries to this part of the hip joint are divided into 2 groups:

  • simple, when the integrity of only one part of the basin, for example, anterior column, the posterior fornix;
  • complex violation of the integrity of the depression, which damaged several of its regions, for example, when the fracture passes through several phases of depression, including injuries to front and rear of the column at the same time.
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Often fracture depression is accompanied by hip dislocation, hip fracture. Sometimes the fracture of the joint with displacement, the bone fragments can go beyond the hip joint in the soft tissue.

The main causes of trauma

The fracture depression is often the consequence of road accident, fall from height, accident in the workplace. Often this injury can be obtain during classes heavy sports.

A fracture of the acetabular bone is most likely to occur when the bus performs arrival on the pedestrian side, if the person hits the bonnet of the car basin.

Thus, the trauma depression often arise due to mechanical forces on the area of the hip joint.

Often injuries TZB combined with other serious injuries.

In the absence of timely and adequate assistance it is possible to complete disability of the victim.

Symptoms and diagnosis

Fractures depression the patient suffers from pain in the groin or in the depth of the hip joint. If there is to be a fracture with displacement of bone fragments, the function of the lower limb is severely disturbed.

If the violation of the integrity of the basin has occurred without displacement of the bone, then active movement possible, but cause severe pain.

When we tap on the calcaneus pain at fracture increases. If the fracture accompanied by a dislocation of the hip, no movement of the lower limb, the patient can not perform.

Limb injuries of the acetabulum may be in an unnatural position to be shortened or turned outwards.

The more accurate the diagnosis, the doctor sets based on x-ray. This is the most informative method of diagnostics of violation of the integrity of the acetabulum, it allows you to assess the nature and severity of the damage.

In some cases, prescribed a CT scan, which is indispensable for the diagnosis of fracture of the posterior wall, it can help you learn more about the fracture that bears comminuted nature.

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The patient in addition to the trauma surgeon inspects also a neurologist, neurosurgeon. These doctors will be able to determine the presence or absence of damage to the nerve fibers in the pelvic region.

Emergency

If you suspect a fracture of the acetabulum need as quickly as possible to call an ambulance. Prior to her arrival, the victim can be given painkillers that are available at hand.

The patient should be put on the back on a hard surface. If possible, put under the knee and the hips small rollers. The patient’s head should be raised. However, it is impossible to abruptly change the position of the feet of the victim.

If the person is seriously injured in the accident, are bleeding, venous or arterial character, it is necessary to stop them. To impose a pressure bandage for venous bleeding and arterial tourniquet.

The complex of therapeutic measures

The goal of therapy is to restore the normal functioning of the hip joint and preventing possible complications.

Depending on the type of fracture, using various methods of treatment. So, if there is to be a fracture without displacement, we impose a standard bus with leykoplastyrb traction. The tire is imposed for about a month. During the rehabilitation period of the patient shown exercise therapy, electrophoresis.

If the fracture is complicated with dislocation of the hip, the doctor will first reduce a joint, and only then impose skeletone traction. All these manipulations are performed under General or local anesthesia.

If the patient has a compound fracture has bone fragments, surgical intervention is necessary. It must conduct, not later than within 7-14 days after injury.

Operation is possible only in case if the patient’s condition is satisfactory. With the help of special screws and plates, the doctor records the fragments of the acetabulum.

Often victims of accidents with a similar injury, prescribe painkillers, anti-inflammatory drugs. In open fractures the therapy with antibiotics.

The recovery period

After a couple of months after the injury, if the patient’s condition is satisfactory, and on the x-rays at the fracture site, visible callus, you can start to carry out rehabilitation activities.

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Before removing skeletal traction, a victim can perform light exercises: flexion and extension of the toes, lift the hips.

After removing the plaster cast, skeletal traction, the patient begins to learn to walk on crutches, stepping on the affected leg. If all is successful, then gradually the patient begins to try to walk independently.

Rehabilitation after fracture of the acetabulum must be accompanied by strict medical supervision.

Prognosis and complications

The prognosis is favorable, but just in case, if the time taken curative measures.

But if this fracture occurs in older people with osteoporosis, and in some other situations you have to resort to joint replacement.

Complications of this injury can become necrosis, osteoarthritis, traumatic arthritis, violation of the integrity of the sciatic nerve and resultant paresis, wound infection, arthrosis of the hip joint.

How to avoid a dangerous injury?

Since such injuries often result from accidents, must observe traffic rules, safety in the workplace.

It is also advisable to engage in regular physical exercises as they are beneficial for musculoskeletal and form a muscular frame. Persons suffering from osteoporosis have weak bones, you need to apply the medications prescribed by your doctor.

Fracture of the acetabulum is a dangerous injury that can lead to disability, therefore, if you suspect its presence, you need to consult a doctor and keep all medical appointments, doing physical therapy during the rehabilitation period.