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Total hip replacement in neglected acetabular fracture

Hip replacement in neglected acetabular fracture
Dr.A.K.Venkatachalam
Consultant Orthopedic surgeon, Chennai,
www.hipsurgery.in

Acetabular fractures are often sustained in four wheeler accidents. Most patients are young. The ideal treatment is internal fixation in displaced fractures. In neglected fractures or following improper fixation, avascular necrosis and secondary osteoarthritis result. In such cases total hip replacement is required. This case report shows a total hip replacement for a neglected acetabular fracture.
Case report- Mr. S A, a 30 year old Nigerian male presented with a neglected acetabular fracture of two years duration.

The head of the femur is lying posteriorly on the ischium.
He was taken up for a one stage acetabular reconstruction and a total hip replacement.
Technique
Acetabular reconstruction was achieved with a cortico cancellous bone graft from the femoral head. The posterior wall was recreated with bone graft fixed in place by a contoured reconstruction plate.
After achieving a contained acetabulum, it was prepared to receive an uncemented Pinnacle cup. This multi holed cup was fixed with four screws. A Corail stem was used on the femora side. The bearings were Ceramic on ceramic.  This case report can be seen here
E mail- drvenkat@kneeindia.com

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