![]() The transverse and posterior wall fractures often require blood transfusion. But in yet another study out of 16 acetabular fracture, 2 fracture required embolization compared to 9 of the 100 pelvic fractures. patients with acetabular fractures needed lower transfusion rate than with pelvic fractures. The respective part played by the various elements producing the shock may be difficult to apportion”. According to Letournel and Judet “the cause of shock relates to severity of trauma and to hemorrhage from the fracture site and often from other visceral lesions. Sometimes acetabular fracture can produce profuse bleeding and shock. Hence, high index of suspicion should be there to rule out vascular injury of the ipsilateral lower limb. There are isolated reports of injury to iliofemoral artery associated with high anterior column fracture and superior gluteal artery injury in displaced fracture into the greater sciatic notch. A careful neurological examination to rule out sciatic and common peroneal nerve injury should be done. These lesions are not apparent initially but become evident later. A closed degloving injury of the subcutaneous tissue which is detached from the underlying fascia-Morel-Lavele lesion must be looked into because of the risk of high infection and wound healing in post-operative period. Local injuries including skin, open acetabular fractures and perineum and scrotal injury must be excluded. Lateral displacement of the anterior superior iliac spine on the affected side might give clue regarding central fracture dislocation of hip. The lower limb will be flexed, adducted and internally rotated in posterior dislocation of hip which is usually associated with posterior wall or column fracture whereas it will be in abducted, extended and externally rotated in anterior dislocation. Other skeletal injuries, like fractures of patella-ipsilateral shaft of femur, tibial plateau fractures and knee ligamentous injury are also looked into. Life threatening injuries like head injury, abdominal and other visceral injury must get priority in the initial evaluation of acetabular fracture. In yet another study, it was noted that axial load pattern of injuries were associated with lung injury, retroperitoneal haematoma, traumatic brain injury and lower extremity fractures whereas incidence of genito-urinary injury, hepatic and splenis injury, pelvic vascular injury are more associated with lateral compressive type of acetabular fracture. The other fracture pattern is caused by direct lateral compression force transmitted through the trochanter or indirect axial force along the femur in extended position of hip joint. Most of the posterior wall or column fractures are caused by axial forces transmitted to the acetabulum by knee and femur with the hip in adducted and flexed position-Dashboard injury. According to him, some of the causative energy of the injury pattern is distributed to long bones before it reaches pelvis and torso, thus producing lower extremity fractures. ![]() reported 27% with traumatic brain injuries, even though there was relatively low rate of abdominal injuries. In a study on patients with combined pelvic and acetabular fractures, Dalal et al. ![]() ![]() Even though most of the acetabular fractures are caused due to axial compression along the femur, driving the femoral head into the acetabulum. There are very few literature available on the relationship of non-orthopedic injuries associated with acetabular fractures. Usually acetabular fractures are associated with other major visceral injuries. The most common cause of injury in acetabular fractures is road traffic accidents and fall from a height. In this chapter, we are describing the clinical features and classification of acetabular fracture in a simple and vivid manner. The Orthopedic trauma association modified Letournel classification and gave computerized coding. They divided acetabular fractures into five simple fracture patterns and five associated fracture pattern. Most commonly used classification is modified Judet and Letournel classification. The most commonly used investigation are anteroposterior, Judet views and 2D/3D computerized tomography. The sciatic nerve injury can be associated with posterior wall or column injuries. A closed degloving injury of the subcutaneous tissue which is detached from the underlying fascia-Morel-Lavelle lesion is also common feature. There can be anterior, posterior or central fracture dislocation associated with this injury. The acetabular fracture are usually associated with visceral and neurovascular injuries. The type of acetabular fractures is mainly depend on the position of the femoral head at the time of injury. They are usually occurring following a high energy trauma. Acetabular fractures are one of the rare injuries.
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