What is the initial treatment of acetabulum fractures?

Updated: Jun 25, 2019
  • Author: David S Levey, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

Unfortunately, patients with fractures of the pelvis and/or acetabulum almost always also experience serious injury to surrounding soft tissue (skin and muscles) and neurovascular structures (nerves, arteries and veins). In addition, especially in the case of pelvic fractures, adjacent organs can be seriously injured. With both types of fracture, there is significant bleeding and risk of nerve damage.

In patients with multiple injuries, treatment begins with the trauma team at the scene and then subsequently in the emergency department (ED)—a team of general surgeons, anesthesiologists and nurses—who work together to control bleeding, address damage to the head and chest and other organs that may have been affected (eg, bladder, intestines), and to stabilize broken bones. During this early resuscitation phase of treatment, the orthopaedic surgeon may need to stabilize the fracture by using an external frame to temporarily hold the bones in proper alignment while other problems are treated. This is called temporary external fixation. Surgeons construct these frames using steel pins that are inserted into the bone and joined together by clamps and rods and can do so very rapidly.

Once the patient is stabilized—bleeding has stopped and other life-threatening injuries have been addressed—the fractures can be treated definitively. Successful treatment for both of these types of fractures requires the skills of an interdisciplinary team, with orthopedic surgeons working closely with the trauma team (general surgeons), the anesthesiologists, and nurses. Following surgery, rehabilitation specialists play a key role in recovery.

Because of the complex nature of these fractures and because many orthopedic surgeons do not regularly treat them, patients who initially go to a community hospital for emergency attention are often transferred to an institution that specializes in such injuries.


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