Fracture of the acetabulum: therapy and the consequences of trauma

Hip joint performs in the human body a huge role, it is one of the largest joints, and also experiences a daily heavy load. It is thanks to him that a person can walk, because he is involved at all stages of the movement.

Fractures of the acetabulum, part of this joint, is a dangerous condition which, in the absence of competent treatment, can lead to serious consequences, disability, and also to worsen the quality of life.

Injury in the acetabulum zone is a violation of the integral structure of the hip bone in the area where the femoral head abuts the pelvic bone.

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

Anatomical and physiological features of the

The acetabular cavity has a spherical shape, is deepened inside the joint, its inner part is lined with articular cartilage.

Facing the acetabulum, it is formed by the fusion of the sciatic, iliac and pubic bone. The cavity consists of the front wall, the rear wall, the front column, the rear column and the arch.

A cartilaginous tissue is located at the edges of the cavity, and the joint itself is covered with a capsule. Inside the hollow is lined with a synovial membrane that produces articular fluid that provides "lubrication" of the joint.

On all sides it is covered with muscles and ligaments. It is due to this complex structure that a strong attachment of the femoral head to the pelvic bones is ensured.

With the help of the hip joint, a person can raise and lower the leg, make circular movements with the hip, move the hip forward and back. Bone columns give the cavity strength.

Classification of fractures

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

• simple , when the integrity of only one part of the cavity is broken, for example, the front column, the rear arch;
• complex - violation of hollow integrity, in which several of its areas were affected, for example, when a fracture passes through several areas of the cavity, including trauma to the front and back columns simultaneously.

Often a fracture of the cavity is accompanied by a dislocation of the hip joint, a fracture of the neck of the hip. Sometimes there is a fracture of the joint with displacement, while bone fragments can go beyond the hip joint into soft tissues.

The main causes of trauma

Fracture of the cavity is often the consequence of an accident, a fall from a high altitude, an accident at work. Often, such a trauma can be obtained during heavy sports.

Fracture of the acetabulum occurs most often when the bus pulls the pedestrian on the side, if a person hits the hood of the car with a basin.

Thus, trauma to the cavity most often occurs when the mechanical force is applied to the hip joint area.

Often, injuries to TZB are combined with other serious injuries.

In the absence of timely and adequate assistance, full disability of the victim is possible.

Symptoms and Diagnosis

The patient suffers from pain in the groin or in the depth of the hip joint at fractures of the cavity. If there is a fracture with a displacement of the bone fragments, the function of the lower limb is severely impaired.

If a violation of the integrity of the cavity occurred without bias, active movements are possible, but cause severe pain.

When tapping the heel bone, the pain in the fracture increases. If the fracture is accompanied by a hip dislocation, then the patient can not perform any movements by the lower limb.

Extremity in acetabular injuries can be in an unnatural position: be shortened or turned outward.

A more accurate diagnosis is made by a doctor based on an X-ray. This is the most informative way of diagnosing the breach of the acetabular wholeness, it allows to evaluate the nature and severity of the damage.

In some cases, computer tomography is prescribed, which is simply indispensable for diagnosing a fracture of the posterior wall, with its help you can study in more detail a fracture that is of a comminuted nature.

In addition to the traumatologist, the patient is also examined by a neurologist, a neurosurgeon. These doctors will be able to determine the presence or absence of damage to the nerve fibers in the pelvic region.

First aid

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

The patient should be laid on his back, on a firm surface. If possible, then place a small cushion under the knee joint and thigh area. The patient's head should be raised. But you can not dramatically change the position of the victim's legs.

If a person is seriously injured in an accident, there are bleeding venous or arterial nature, then it is necessary to stop them. Apply a pressure bandage for venous bleeding and a tourniquet in the arterial.

Therapeutic measures package

The aim of the therapy is to restore the normal functioning of the hip joint and prevent possible complications.

Depending on the type of fracture, various methods of treatment are used. So, if there is a fracture without a bias, then a standard tire with a plaster-stretching stretch is applied. The tire is applied for a period of about a month. During the rehabilitation period of the , the patient is shown exercises of exercise therapy, electrophoresis.

If the fracture is complicated by a hip dislocation, the physician first restrains the joint, and only then the skeletal traction is applied. All these manipulations are performed under general or local anesthesia.

If the patient has a difficult fracture, there are bone fragments, then surgery is mandatory. It must be carried out no later than 7-14 days after the injury.

Operation is possible only if the patient's condition is satisfactory. With the help of special screws and plates, the doctor fixes the fragments of the acetabulum.

Often, victims of an accident with a similar injury are prescribed analgesics, anti-inflammatory drugs. With open fractures, therapy is performed with antibiotics.

Recovery period

A couple of months after the injury, if the patient's condition is satisfactory, and on the x-ray at the site of the fracture, bone callus is visible, you can begin to carry out rehabilitation measures.

Even before removal of the skeletal traction, the victim can perform light exercises: bend and unbend his toes, lift the pelvis.

After removal of gypsum, skeletal traction, the patient begins to learn how to walk on crutches, step on the aching leg. If everything goes well, then gradually the patient begins to try to walk on his own.

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

Prognosis and complications

The prognosis for the patient is favorable, but only if all medical measures are taken in time.

But if such a fracture occurs in elderly people suffering from osteoporosis, and in some other situations it is necessary to resort to endoprosthetics.

Complications of this trauma may be necrosis, osteoarthrosis, traumatic arthritis, disruption of the sciatic nerve, and as a consequence, its paresis, wound infection, arthrosis of the femoral joint.

How to avoid dangerous injury?

Since such injuries most often occur as a result of accidents, it is necessary to comply with traffic rules, safety at work.

It is also advisable to exercise regularly, as they have a beneficial effect on the musculoskeletal system and form a muscular framework. Persons suffering from osteoporosis who have fragile bones need to use medicines prescribed by the doctor.

Fracture of the acetabulum is a dangerous injury that can lead to disability, which is why if you suspect it is necessary to consult a doctor, as well as to comply with all medical appointments, engage in physical therapy during rehabilitation.