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  4. Indications
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Authors of section

Authors

Tania Ferguson, Daren Forward

Executive Editor

Richard Buckley

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Anterior wall

 
 
 
 
 

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 and 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.

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 and 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 indications

 
 
Most fractures with no intraarticular fragments identified on CT

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
Most fractures with no intraarticular fragments identified on CT

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 indications

 
 
Large, isolated anterior wall fragment

Indications

  • Incongruent hip joint
  • Unstable hip joint

Disadvantages

  • Risks of surgery
Large, isolated anterior wall fragment

Indications

  • Incongruent hip joint
  • Unstable hip joint

Disadvantages

  • Risks of surgery