Intraoperative acetabular fracture during insertion with unstable component
General considerations
Intraoperative fractures that occurred during the insertion of a cup, with an unstable component, are classified as IB type fractures by Della Valle.
Type IB fractures have a stable or unstable pattern with loss of cup stability.
Type IB fractures have a stable or unstable pattern with loss of cup stability.
Della Valle I acetabular fracture occur intraoperatively during hip arthroplasty.
Further information about Della Valle classification can be found in the publication: Della Valle CJ, Momberger NG, Paprosky WG. Periprosthetic fractures of the acetabulum associated with a total hip arthroplasty. Instr Course Lect. 2003;52:281–290.
Etiology
- Excessive or eccentric reaming leading to reduction of bone strength
- Mismatch of cup size to the reaming preparation
- Eccentric cup insertion leading to stress of the walls/columns
Clinical signs
- Visible fracture line
- Unstable cup by press-fit technique
Imaging
- Visual inspection and recognition are generally sufficient
- Fluoroscopy or regular radiographs may further define the extent of the fracture patterns
