Acetabulum Fractures: Mechanism of Injury, Demographic Features and Associated Injuries

Muhammad Arif. Acetabulum Fractures: Mechanism of Injury, Demographic Features and Associated Injuries. Biomed Objectives: The study about the demographic characteristics of patients about common associated injuries and various Study Design:


Introduction
The acetabulum is a cup shaped depression on the outer surface of the hip bone and it articulates with the head of the femur. Acetabular fractures occur when the head of femur is pushed into the pelvis by a lateral blow to the hip or by an anterior blow to the knee with hip in flexion and abduction [1]. Acetabulum fracture has rare incidence of about 5/100,000 people per year, as compared to proximal femur fractures, which has about a hundred times higher incidence, based on geographical areas [2]. However, this rate is on the rise worldwide as a result of increase in road traffic accidents and high impact injuries1.About 80% of acetabular fractures result from high energy trauma like in road traffic accidents and around10.7% result from fall from a significant height [3].
Acetabulum fracture present more often in multiple trauma patient and are considered as serious injury [3]. Patients present to emergency department with history of pain or a hip deformity, usually with other associated injuries such as hip dislocation, femoral neck fracture or sciatic nerve palsy. They can also present with trauma to the surrounding structures like peri-pelvic soft tissues, extremity fractures, trauma to major abdominal viscera and chest injuries [4]. Pelvic insults can be diverse, ranging from minor lacerations to major debilitating complex acetabular fractures [4].
Different factors are associated with mortality and morbidity of patient including mechanism and the energy of initial insult, age, male gender, cardiac diseases, dementia, institutionalization and rehabilitation. That should be carried out after hip trauma and plays a significant role in patient recovery [5][6][7].
In general, operative treatment of an acetabular fracture should not be performed as an emergency except when it is a part of open fracture management or is performed for a fracture associated with an irreducible dislocation of the hip. In such cases, the top priority would be resuscitation followed by Advanced Trauma Life Support protocols [8]. The aim of our study is to assess the pattern of acetabulum fractures presenting to our unit and the injuries they are associated with in relation to the initial mechanism and severity of trauma.

Methods
This study is a case series for which data was collected from        to their style of work and the frequency was low in the females.
88% injuries were accounted in males. The results are similar to the study by Giannoudis, et al. [3] where injuries were mostly accounted for males. The study found that the mean age for the patient was 34 years, which was similar to other studies [9]. The current study found that two fracture types were most commonly presented i.e. posterior wall fracture20(28.99%)and both column fracture17(24.64%).Thirty-nine patients had associated injuries out which injured hip dislocation was prevalent i.e. 11(28%). The same were also experienced in their study by Hussain, et al. [1]. In our study we found that open reduction and internal fixation was the preferred and major management practices for the patient.
According to study 71% cases was fixed using open reduction and internal fixation. The same was similar with the study of (S. Hoge and B. J 2019) [10] who found that most of the fracture required open reduction and internal fixation. Similar operation rate were reported by other authors [11][12][13]14]. The study found that out of those patients who were surgically managed 81% patients' fracture was approached via Kocher-langenbeck approach, which almost similar to the rates in literature [14][15][16][17].

Conclusion
Acetabular fractures are common in young adults and the most common mechanism of injury is road traffic accidents. The common fractures are posterior wall and both column injuries and associated with hip dislocation. The preferred method of treatment is surgical fixation through Kocher langenback approach.