Pelvic Acetabular Fracture

A pelvic acetabular fracture refers to a break in the pelvic ring or the acetabulum—the socket portion of the hip joint that connects with the femoral head. These fractures are often serious and result from high-energy trauma such as car accidents, falls from heights, or crush injuries. The pelvis plays a key role in supporting body weight and mobility, so fractures in this area can cause severe pain, instability, and difficulty walking. Accurate diagnosis and timely treatment are critical for restoring hip joint function and preventing complications.

The need for treatment arises when the pelvis or acetabulum is fractured due to significant trauma. These injuries often involve multiple breaks and can be associated with damage to surrounding organs, blood vessels, or nerves. Patients typically present with intense pain in the hip or groin area, inability to walk, and swelling or bruising. Immediate medical assessment, including imaging studies, is necessary to determine the fracture type and severity, and to formulate an effective treatment plan.

Treatment varies depending on the stability and pattern of the fracture. Non-surgical options like bed rest, traction, or use of external braces are suitable for stable fractures without displacement. Complex or displaced fractures typically require surgical fixation using plates, screws, or rods to realign and stabilize the bones. The goal of treatment is to restore joint congruity, allow for proper bone healing, and maintain hip function. Early intervention helps reduce the risk of long-term complications like arthritis or joint dysfunction.

Before surgery, patients undergo comprehensive imaging including X-rays, CT scans, and possibly MRI to assess the fracture configuration. The orthopedic surgeon will explain the surgical plan, risks, and expected outcomes. Preoperative preparation includes stopping medications that affect blood clotting, performing isometric exercises, and evaluating overall health. It is important to plan for mobility aids such as walkers or wheelchairs and to organize help at home, as movement will be significantly limited after surgery.

Surgery is performed under general or spinal anesthesia and involves accessing the fracture site through carefully planned incisions. The surgeon realigns the fractured bones and secures them using metal implants. The procedure may take 2 to 4 hours, depending on the complexity. In cases of acetabular fractures, care is taken to restore the shape of the hip socket for optimal joint function. After the implants are secured, the surgical site is closed and the hip area is dressed and supported for recovery.

Post-surgery, patients are closely monitored and given instructions for pain management, wound care, and mobility precautions. Weight-bearing is usually restricted for several weeks, and patients may need assistance with daily activities. Pain and inflammation are managed with medications and cold therapy. Early physical therapy helps maintain joint flexibility and prevent muscle atrophy. Light activity may resume in 6–8 weeks, though full mobility will take longer. Adherence to post-op protocols is vital for successful healing.

Rehabilitation is essential to regain mobility and strength after a pelvic acetabular fracture. Therapy begins with gentle range-of-motion exercises and advances to partial weight-bearing and gait training. Over a period of 3 to 6 months, patients work to rebuild strength, balance, and endurance. Long-term, some may experience residual stiffness or weakness, but most regain functional mobility with proper care. Regular follow-ups are important to monitor bone healing, implant position, and hip joint function.