Authors of section


Derek Donegan, Michael Huo, Michael Leslie

Executive editor

Michael Baumgaertner

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Traumatic acetabular fracture with unstable component

General considerations

Traumatic fracture to the prosthetic joint remote from surgery with an unstable cup are classified as Della Valle IIIB. These may be high or low energy and are greatly affected by the underlying bone stock of the patient.

The cup instability can be defined with serial radiographs and the patient's clinical symptoms prior to the injury.

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.

Della Valle IIIB acetabular fracture


  • High energy collision
  • Low energy fall

Clinical signs

  • Pain
  • Possible associated dislocation
  • Leg length discrepancy


  • Regular radiographs including Judet views
  • CT scan
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