UMEM Educational Pearls

Title: Visual diagnosis-pelvis

Category: Trauma

Posted: 12/8/2024 by Robert Flint, MD (Updated: 12/9/2024)
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Question

What is the diagnosis? Treatment? Other imaging indicated? 

Answer

Acetabulum fracture. 
Usually seen in high mechanism situations such as MVCs. Can be seen in elderly fall patients. 
Treatment is usually surgical (ORIF) unless non-displaced or if it involves less than 20% of posterior column. These can be managed with 6 weeks of minimal weight bearing. CT scan is almost universally used for better visualization and operative management. 

“Some landmarks of the hip are compared on the right and left sides of the pelvis:

  • iliopectineal line - disruption indicates anterior column fracture
  • ilioischial line - disruption indicates posterior column fracture
  • acetabular roof“          Radiopedia

References

https://radiopaedia.org/cases/acetabular-fracture-anterior-and-posterior-columns

https://www.orthobullets.com/trauma/1034/acetabular-fractures