Executive Editor: Richard Buckley

Authors: Tania Ferguson, Daren Forward

Acetabulum - Anterior wall

back to skeleton

Glossary

General considerations

Anterior wall fractures are often present as part of other anterior fracture patterns.

Most isolated fractures will be treated non-operatively.

Large isolated fractures are suitable for reduction and fixation.

Surgery is urgent for:

  • Irreducible dislocation
  • Hip joint incongruity with risk of femoral head damage

ORIF is the optimal operative treatment for most fractures. For severe arthrosis or osteoporosis, total joint replacement should be considered.

Nonoperative treatment
Main indication Skill Equipment
Most fractures with no intraarticular fragments identified on CT Highly experienced and skilled surgeon Basic equipment only

Indications

  • Undisplaced fractures
  • Congruently reduced hip joint
  • Stable hip joint through range of motion
  • No evidence of progressive displacement
  • Very low fractures of the anterior wall (acetabular roof arc angle >45°)

Advantages

  • Avoidance of risks of surgery

Disadvantages

  • Risk of bad outcome
  • Residual displacement may compromise hip replacement
ORIF through ilioinguinal approach
Main indication Skill Equipment
Large, isolated anterior wall fragment Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • Incongruent hip joint
  • Unstable hip joint

Disadvantages

  • Risks of surgery
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2017-11-27