Pelvic discontinuity
General considerations
A pelvic discontinuity is due to chronic conditions where acetabular bone stock has been diminished. This can be classified as a Della Valle V fracture.
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
- Trauma in the presence of major bone defects either from previous reaming or pelvic osteolysis
- Migration of the loose cup resulting in the disruption of column stability
- Complication from cup insertion during surgery
- Complication from cup removal of a loose or a well-fixed cup.
- Type V fractures are directly related to bone loss due to pelvic irradiation.
Clinical signs
- Pain
- Leg length inequality due to cup migration
- Hip dislocation due to cup migration
Imaging
- Regular radiographs including Judet views
- CT scan
