We retrospectively analyzed 22 patients pelvic CT, in whom the acetabular fracture were suspected in plain film. And compared and analyzed the computed tomogram findings and plain radiographic findings. The results were as follows. CT enables better evaluation of shape, extent, and degree of separation of fragment. CT was helpful in detecting the combined fracture and soft tissue injuries. CT showed intraarticular loose bodies, which were invisible on plain film. In patients with pelvic trauma, no necessary changing position during CT examination. CT was useful demonstrates the remnant of intraarticular osseous fragment and adequacy of reduction after surgery.
Acetabulum* ; Humans ; Retrospective Studies ; Soft Tissue Injuries

Acetabulum ; injuries ; surgery ; Fractures, Bone ; surgery ; Humans

Percutaneous pelvic fixation is possible with the advances in intraoperative fluoroscopic imaging and other technologies. Percutaneously inserted screws in medullary pubic ramus,iliac wing, and iliosacral bone can stabilize pelvic or acetabular disruptions directly mean while can diminish operative blood loss, shorten operative time, and allow patient's early activity. Complications associated with open surgical procedures are similarly avoided by using percutaneous techniques. Stable and safe percutaneous fixation techniques depend on accurate closed reduction, excellent intraoperative fluoroscopic imaging, and detailed preoperative planning. A thorough knowledge of pelvic osseous anatomy, injury patterns, deformities, and the related intraoperative imagery techniques are essential for doctors to fulfill the operation of percutaneous pelvic fixation. This paper presents an overview of the technique of percutaneous surgery of the pelvis and acetabulum.
Acetabulum ; injuries ; Fracture Fixation, Internal ; methods ; Humans ; Pelvic Bones ; injuries

PURPOSE: To evaluate the results of limited open reduction and screw fixation of acetabular fractures. MATERIALS AND METHODS: Six acetabular fractures were treated with fluoroscopic guided screw fixation. The mean age was 46 years old and mean follow-up period was 18 months. There were 3 anterior column fractures, 2 transverse fractures and 1 both column fracture. Anterior column screw fixation was used in 5 cases and posterior column fixation in 1 case. Limited ilioinguinal approach was used in 4 cases and percutaneous screw fixation in 2 cases. RESULTS: The mean union time was 16.6 weeks. The postoperative radiographic results revealed 2 cases with an anatomic reduction and 4 cases with an imperfect reduction. The clinical results showed 1 case with excellent, 4 cases with good and 1 case with fair. Regarding complication, there was 1 case of SI joint penestration without clinical symptoms. CONCLUSION: Limited open reduction and screw fixation can be a useful alternative treatment for acetabular fractures in patients with minimally displaced fracture, severe multisystem trauma and soft tissue injury not suitable to traditional treatment.
Acetabulum* ; Follow-Up Studies ; Humans ; Joints ; Soft Tissue Injuries

OBJECTIVETo explore morphological character and clinical significance of superior-posterior acetabular wall by anatomically measuring and quantitatively analyzing thickness of posterior acetabular wall, then provide a theoretical reference for clinical treatment of acetabular fracture.

METHODSFifteen adult formalin-preserved cadaveric pelvises (8 males and 7 females) were used for this investigation. Excess soft tissue was removed and the whole acetabular posterior walls were marked with "angle" sector method and the thickness was measured with caliper in different levels of the different split points. The measurement results were validated and analyzed statistically.

RESULTSAt 5 mm away from acetabular rim, the average thickness of superior-posterior acetablar wall fluctuated between (6.47±0.61) mm and (7.43±0.71) mm; the average thickness of inferior-posterior acetabuluar wall fluctuated between (5.62±0.51) mm and (6.33±0.61) mm; the average thickness of acetabular roof fluctuated between (7.71±0.74) mm and (8.27±0.99) mm. There was no statistical difference between average thickness of superior-posterior wall of acetabulum and inferior-posterior wall of acetabulum (P>0.05), but the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P<0.05). At 10 mm away from the acetabular rim, the average thickness of superior-posterior acetabular wall fluctuated between (8.81±0.67) mm and (13.35±0.89)mm; the average thickness of inferior-posterior acetabular wall fluctuated between (7.02±0.63) mm and (7.66±0.69) mm; the average thickness of acetabular roof fluctuated between (14.46±0.97) mm and (17.05±1.35) mm. Comparatively, the average thickness of superior-posterior acetabular wall was significantly larger than inferior-posterior wall of acetabulum (P<0.05), and the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P<0.01). At 15 mm away from the acetabular rim, the average thickness of superior-posterior acetabular wall fluctuated between (12.08±0.78) mm and (19.84±1.03) mm; the average thickness of inferior-posterior acetabular wall fluctuated between (10.17±0.76) mm and (11.12± 0.77) mm; the average thickness of acetabular roof fluctuated between (23.23±1.12) mm and (26.01±1.53) mm. Comparatively, the average thickness of superior-posterior wall of acetabulum was significantly larger than inferior-posterior acetabular wall (P<0.01), and the average thickness of acetabular roof was significantly larger than superior-posterior acetabular wall (P< 0.01).

CONCLUSIONThe thickness of entire acetabular posterior edge revealed an increasing tendency from inferior-posterior wall to the superior-posterior wall to acetabular roof. And this trend became more obvious with increasing distance away from acetabular rim. Therefore, the superior-posterior acetabular wall could not only maintain the stability of hip joint but also bear loading.

Acetabulum ; anatomy & histology ; injuries ; surgery ; Female ; Humans ; Male

In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initialradiographs, we compared and analysed the CT findings and plain radiographic findings and plain radiographicfindings. The results were as follow: 1. In patients with multiple trauma, no further change in position wasrequeired during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plainradiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, andfemoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments.5. CT was helpful indetecting the associated fractures and soft tissue injuries. 6. CT also demonstrated theadequacy of reduction, the position of metallic fixation devices, and the presence or absence of remainingintraarticular osseous fragments after surgery.
Acetabulum ; Head ; Humans ; Multiple Trauma ; Retrospective Studies ; Soft Tissue Injuries

OBJECTIVE: To review the literature regarding diagnosis and treatment of labral tear. DATA SOURCES: A systematic search was performed in PubMed using various search terms and their combinations including hip, labrum, acetabular labral tear, arthroscopy, diagnosis, and anatomy. STUDY SELECTION: For each included study, information regarding anatomy, function, etiology, diagnosis, and management of acetabular labral tear was extracted. RESULTS: Five hundred and sixty abstracts about anatomy, function, etiology, diagnosis, and management of acetabular labral tear were reviewed and 66 selected for full-text review. The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown. CONCLUSIONS Labral tear is generally secondary to femoroacetabular impingement, trauma, dysplasia, capsular laxity, and degeneration. Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test. Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard. Conservative treatment consists of rest, non-steroidal anti-inflammatory medication, pain medications, modification of activities, physical therapy, and intra-articular injection. When fail to respond to conservative treatment, surgical treatment including labral debridement, labral repair, and labral reconstruction is often indicated.
Acetabulum ; injuries ; Arthroscopy ; Hip Injuries ; Humans ; Rotator Cuff Injuries ; Rupture ; diagnosis

PURPOSE: To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. MATERIALS AND METHODS: We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). RESULTS: All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%), the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in the posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. CONCLUSION: Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.
Acetabulum ; Dislocations ; Head ; Hip ; Hip Dislocation ; Humans ; Joints ; Muscles ; Retrospective Studies ; Soft Tissue Injuries

OBJECTIVETo discuss the diagnosis and operative technology of acetabular fracture.

METHODS41 cases of displaced acetabular fractures were enrolled. CT and 3D-CT were performed before operation to understand the classification of fractures and to determine operative regimen. All cases were fixed by reconstruction plates and screws through the best approach.

RESULTS39 cases were followed up for 1 - 4 years, with an average of 1.5 years. Curative outcomes were assessed by Matta's criteria. Clinically, 16 (53.3%) 30 fresh fractures were excellent, 11 (36.7%) good, 3 (10%) fair. The rate of excellence and goodness was 90%. In 9 cases of old fractures, 2 were excellent, 3 good, 2 fair and 2 poor. The rate of excellence and goodness was 55.6%. Complications consisted of sciatic never injury, necrosis of the femoral head, and heterotopic ossification.

CONCLUSIONSThe time of operation, degree of injury, and quality of reduction of fracture are important factors affecting the postoperative function of the hip. The key to enhance the outcome is to verdict the type of fracture, select the proper approach before operation, and precise reduction and appropriate internal fixation during operation.

Acetabulum ; injuries ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

Acetabulum, as the important factor for weight bearing of the upper body, has its unique anatomic features and complicated physiological function. The integrity and stability of the lunata articular surface in the dome region of acetabulum, is the important base to bear the physiological function of acetabulum. The fracture related to this part will cause relation change of contact area and stress between head of femur and acetabulum. Furthermore, the deep anatomical position of the dome region, the complicated surrounding anatomical relation, and the irregular bony structure will also increase the difficulty of surgical treatment. Especially for some complicated comminuted or compressed fracture, even with good explosions, it is hard to get satisfied anatomical reduction. Consequently,forward traumatic arthritis has greater probability of occurrence. Therefore, the clinical research on the fracture in the dome region of acetabulum was getting more and more attention worldly. This paper intended to review the relation of fracture classifications and anatomic features, physiological function,diagnostic criteria,and also its clinical treating countermeasure.
Acetabulum ; injuries ; physiopathology ; surgery ; Fractures, Bone ; diagnosis ; physiopathology ; surgery ; Humans ; Prognosis ; Weight-Bearing