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.
|Most fractures with no intraarticular fragments identified on CT|
- 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°)
- Avoidance of risks of surgery
- Risk of bad outcome
- Residual displacement may compromise hip replacement
|ORIF through ilioinguinal approach|
|Large, isolated anterior wall fragment|
- Incongruent hip joint
- Unstable hip joint
- Risks of surgery
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|