Surgical Treatment of Acetabular Posterior Wall Fracture with Hip Arthroscopy: A Case Report

Abstract

Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

Surgical Technique: Arthroscopic Reduction and Fixation of Partial Posterior Wall Acetabular Fractures

“…The patient exhibited complete union in 3 months per follow-up radiographs, although long-term outcomes were not reported. 6 Stabile 15 et al. 16 recounted the case of a 46-year-old woman who experienced a posterior acetabular fracture-dislocation due to a motor vehicle collision.…”

Femoral head cartilage reconstruction using autologous osteochondral mosaicplasty: A case report

“…The decision to intervene in a fracture of the femoral head is largely based on fracture location and size and treatment often consists of simply removing the loose bodies and debriding the cartilage. [ 6 ] Such treatment may yield a satisfactory outcome when the injury is located in the non-weight-bearing region, but it may result in secondary osteoarthritis if it occurs in the weight-bearing zone or involves concomitant loose body remnants. [ 7 ] Therefore, when the fracture is accompanied by extensive cartilage damage, surgical restoration should be considered to prevent further joint destruction.…”

Arthroscopic Reduction and Internal Fixation in Patients with Acetabular Posterior Wall Fractures

“… 15 16) However, the hip arthroscopic technique has fewer complications than the open reduction technique described above and has the additional advantage of less invasive approach, joint washing, confirmation of reduction, and faster postoperative recovery. 17) …”