However, all orthopaedic surgeons should be comfortable with the diagnosis and initial management of these injuries. Due to the relative rarity of acetabular fractures and their typically higher energy mechanisms, treatment of these injuries is ideally performed by surgeons with advanced training working at specialized hospitals that focus on the care of multiply injured patients. 3– 6 Increased experience with the treatment of these types of injuries improves the treating physician′s ability to correctly evaluate radiographs, determine the appropriate surgical approach, perform adequate reductions, and understand the impact of associated injuries on treatment. When such injuries are treated surgically, hip joint preservation and maintenance of hip function typically result if operative complications are avoided. Fractures of the acetabulum that are displaced and result in a loss of congruence between the femoral head and the remaining intact portion of the superior articular surface typically have a poor prognosis. Judet and colleagues 1 and Letournel 2 defined the socket as being supported from the sciatic buttress by two columns of bone: the anterior column (made up of the ilium and pubis) and the posterior column (made up of the ischium) ( Fig.
It articulates with the femoral head in a highly constrained joint. The acetabulum is a socket of bone formed from the fusion of the ilium, ischium, and pubis at the triradiate cartilage.
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