Injuries of the acetabular triradiate cartilage and sacroiliac joint

Abstract

Four patients with injuries of the acetabular triradiate cartilage are presented. In three of them premature fusion of the cartilage occurred; two of these developed acetabular deformity and subluxation of the hip. In all patients the sacroiliacjoint also was injured; in two, thejoint was completely disrupted, leading to fusion and growth disturbance of the ilium. As injury ofthe triradiate cartilage is easily missed on the initial radiograph, it is advised that all patients with pelvic trauma should be followed clinically and radiographically foratleast one year. The acetabular triradiate cartilage is the composite growth-plate of the iliac, ischial and pubic bones. Premature closure of this physis is an infrequent complication

Case Reports: Treatment of Traumatic Triradiate Cartilage Epiphysiodesis: What is the Role of Bridge Resection?

“…Complete or partial growth arrest of the triradiate cartilage may be seen after pelvic fractures [1,2,7,15,16,18], infection [4,20], or iatrogenic damage after pelvic osteotomy [13] .The consequences of physeal growth disturbance, shown by experimental [5,6] and clinical studies [1,2,15,16,18], include acetabular dysplasia and subluxation or dislocation of the femoral head. Conceptually, restoration of normal growth is the goal of treatment no matter the location of the physeal bar; in most locations, this is achieved surgically.…”

Development and Injury of the Triradiate Cartilage with its Effects on Acetabular Development

“…It is composed of the nonarticular triradiate medially (one third) and the cup-shaped articular acetabular cartilage laterally (two thirds). 2,3 The triradiate cartilage has been described as having three flanges. The first is anterior and superior, lying between the ilium and pubis.…”

“…Acetabular development occurs by a combination of enchondral, interstitial, and appositional growth. [1][2][3][4] Acetabular development can be adversely affected by triradiate cartilage trauma. Injury to its blood supply can lead to premature physeal closure.…”

“…1,4,6,9,10 Resultant premature closure of the triradiate cartilage has an overall incidence of less than 5% (range, 0 -11%) in pediatric patients with acetabular fractures. 2,4,8 Differences in structure, quality, and ratios of bone and cartilage account for differences in the incidence, pattern of injury, and functional outcome of pediatric versus adult patients.…”

Traumatic bilateral posterior hip dislocation in 10 year old male child

“…Pietrafesa and Hoffman demonstrated that 62e93% of hip dislocations result from motor vehicle crashes. 12 For bilateral posterior hip dislocation to happen it need both hip must be loaded while in attitude of flexion, a posterior dislocation is produced when the flexed knee strikes against the dashboard with the hip flexed and adducted. In u r n a l o f c l i n i c a l o r t h o p a e d i c s a n d t r a u m a 5 ( 2 0 1 4 ) 1 5 4 e1 5 6 our case child was fallen on ground from tractor seat located around the height of 8 feet on his knees over ground.…”