Journal of Musculoskeletal Trauma

Single Percutaneous Retrograde Anterior Column Screw Fixation in a Minimally Displaced Transverse Acetabular Fracture - A Case Report -: Seungyup Shin, Jinkyu Park, Sungho Lee; J Korean Fract Soc 2023;36(2):57-61. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.57

Abstract PDF: According to the Letournel classification, a transverse fracture is the only elementary fracture pattern that breaks both the anterior and posterior border of the innominate bone. A transverse acetabular fracture separates the innominate bone into two segments: the iliac segment and the ischiopubic segment. Therefore, minimally displaced transverse fractures can be stabilized by purchasing both segments with a large-diameter single screw. Although it is not a stable internal fixation construct compared with plates and screws, it provides sufficient stability to promote early mobilization and early weight-bearing while minimizing the risk of secondary displacement and preventing secondary complications associated with prolonged bed rest and immobilization. The authors successfully treated a case of minimally displaced transverse acetabular fracture with percutaneous column fixation using a retrograde fashion of a single anterior column screw. This report discusses the case with a literature review and deliberates the usefulness of the procedure.

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Simulation for Reduction of Transverse Acetabular Fractures in Sawbones Models: Seongeun Byun, Cyril Mauffrey, Jehyun Yoo, Changwon Park, Jihyo Hwang; J Korean Fract Soc 2019;32(4):196-203. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.196

PURPOSE
The transversely oriented fracture lines are very difficult to reduce during operations, even after clear exposure of the fracture site, in acetabular fractures. The purpose of this study is to verify the quality of reduction between the different subtypes (transtectal, juxtatectal, and infratectal) of transverse fractures. This study also determined the proper type of clamps to use and the proper zone for achieving accurate reductions in Sawbones models.
MATERIALS AND METHODS
Six fractures in 3 different subtypes of transverse fractures were artificially created. Ten different reduction clamps were applied for reduction of the fractures. Twelve holes around the fracture were drilled for the maintenance of the clamps. The fracture displacements were measured at the extra-articular area and the intra-articular joint portion. The pictures of the intra-articular fracture displacements were taken by a camera and these were uploaded and analyzed by the TraumaCadÂ® computer program (Brainlab).
RESULTS
The reduction quality was poor in order of transtectal, juxtatectal and infratectal. The intraarticular opening was more prominent in the transtectal subtype. The safe zone, when giving consideration of the neurovascular bundles, was a quadrilateral surface of the ilium. Drill holes are useful for maintenance of the reduction clamps. Reduction clamps with points (Weber clamp) were the best for maintenance and accurate reduction. Regarding the concerns of placement of clamps, the middle to posterior combination was the best. The upper hole among the posterior holes in the ilium was the most likely to well reduce the intra-articular opening.
CONCLUSION
Transtectal was the more complicated subtype in the aspect of reduction quality. The Weber type reduction clamp was the best for reduction by centrally located holes in the quadrilateral surface and posteriorly located iliac holes in transverse acetabular fractures. The upper hole, among the posterior holes in the ilium, was the best for reduction of the fracture displacements in the intraarticular portion of acetabulum.

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Surgical outcomes of transverse acetabular fractures and risk factors for poor outcomes
Jae Hoon Jang, Nam Hoon Moon, Seung Joon Rhee, Seok Jin Jung, Tae Young Ahn
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef

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Anterior Approach for the Acetabular Fractures: Jae Youn Yoon, Jae Woo Cho, Ji Wan Kim; J Korean Fract Soc 2019;32(3):157-164. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.157

Abstract PDF

In the surgical treatment of acetabular fractures, the anterior approach is used widely for anterior column fractures with or without posterior column fractures. This paper reviews the anterior approach for the anatomical reduction and rigid fixation of acetabular fractures: traditional ilioinguinal approach, modified Stoppa approach, and new Pararectal approach.

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Adhesion of External Iliac Vessels Found in a Modified Stoppa Approach to Acetabular Fracture in a Patient with a History of Previous Abdominal Surgery
Seong-Tae Kim, Seungyup Shin, Hohyoung Lee, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2022; 57(1): 68. CrossRef

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Reduction Technique of Dome Impaction Using the Modified Stoppa Approach: A Technical Note: Ji Wan Kim, Yong Min Seo, Hyo Seok Jang; J Korean Fract Soc 2017;30(3):131-136. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.131

Abstract PDF

In elderly acetabular fractures, central dislocation of the femoral head and impacted superior dome of the acetabulum is common. Unreduced dome impaction can lead to degenerative arthritis and results in poor results. Herein, we present a case of operative reduction and fixation performed via the modified Stoppa approach in acetabular fracture with superior dome impaction.

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Surgical outcomes of acetabular fracture of elderly patients with superomedial dome impaction
Eic Ju Lim, Hyun-Chul Shon, Jae-Young Yang, Joosuk Ahn, Jung Jae Kim, Ji Wan Kim
Scientific Reports.2023;[Epub] CrossRef
Anterior Approach for the Acetabular Fractures
Jae Youn Yoon, Jae-Woo Cho, Ji Wan Kim
Journal of the Korean Fracture Society.2019; 32(3): 157. CrossRef

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Sexual Activity at 1 Year after Acetabular Fracture: Chan Ho Park, Young Kyun Lee, Kyung Hoi Koo; J Korean Fract Soc 2017;30(3):111-116. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.111

Abstract PDF

PURPOSE
Change in sexual activity after acetabular fracture has not been elucidated to date. Hence, the purpose of this study was to reveal: (1) how acetabular fracture affects the status of sexual activity; (2) how acetabular fracture affects patient satisfaction about sexual activity; and (3) what are the concerns of patients regarding sexual activity.
MATERIALS AND METHODS
Between January 2014 and December 2014, a self-reported questionnaire was conducted with patients who had been sexually active before the treatment for acetabular fracture. Out of the nineteen patients who participated in the questionnaire, twelve men and three women were included for final analysis; patients who were treated conservatively were excluded.
RESULTS
All patients had hip pain (mean visual analogue scale score, 2.9; range, 1-7) at 1 year after the trauma. Fourteen patients (93.3%, 14/15) resumed sexual activity within 1 year (mean, 3.9 months; range, 2â€“6 months). After excluding one patient who did not recover to allow sexual activity, the frequency of sex was decreased in 11 patients (78.6%, 11/14). Sexual satisfaction was decreased in seven patients (46.7%, 7/15). Old age was associated with decreased sexual satisfaction.
CONCLUSION
Half of the patients showed a decreased satisfaction from sexual activity after acetabular fracture, with hip pain being the most common problem. Although our study was a small, single-center study, it provides information regarding sexual activity of patients after acetabular fracture.

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Sexual and Urinary Dysfunction Following Isolated Acetabulum Fractures: A Systematic Review of the Literature
Sophia M. Wakefield, Nikolaos K. Kanakaris, Peter V. Giannoudis
Journal of Clinical Medicine.2025; 14(1): 230. CrossRef
The Impact of Surgical Approaches for Isolated Acetabulum Fracture on Sexual Functions: A Prospective Study
Ibrahim Alper Yavuz, Can Aykanat, Cagdas Senel, Fatih Inci, Erman Ceyhan, Yılmaz Aslan, Altug Tuncel, Ahmet Ozgur Yildirim
Journal of Orthopaedic Trauma.2022; 36(3): 124. CrossRef

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Modified Stoppa Approach in Acetabular Fractures: Ji Wan Kim, Young Chang Kim; J Korean Fract Soc 2014;27(4):274-280. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.274

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the clinical results of modified Stoppa approach in acetabular fractures.
MATERIALS AND METHODS
Twelve patients who underwent surgery using the modified Stoppa approach for acetabular fractures were enrolled. There were 10 cases of isolated acetabular fracture, two cases of acetabular fracture combined with pelvic ring injury. There were two cases of anterior column fracture, nine cases of both column fracture, and one case of T-type fracture according to Letournel classification. The clinical outcomes were evaluated from Harris hip score (HHS) at postoperative one year and complications. The radiologic result was evaluated according to Matta criteria; anatomical, imperfect, and poor.
RESULTS
According to the radiological results, there were eight cases of anatomical, three cases of imperfect, and one case of poor reduction. The average HHS was 82.5 and 10 patients had excellent or good results. The other two patients had poor results due to lumbosacral plexopathy and poor reduction, respectively. The complication included one case of incomplete sciatic nerve palsy, which was recovered at postoperative three months.
CONCLUSION
Internal fixation of acetabular fractures using the modified Stoppa approach had satisfactory clinical and radiological outcomes. The modified Stoppa approach can be a useful option for acetabular fractures with appropriate indication and anatomical information.

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Adhesion of External Iliac Vessels Found in a Modified Stoppa Approach to Acetabular Fracture in a Patient with a History of Previous Abdominal Surgery
Seong-Tae Kim, Seungyup Shin, Hohyoung Lee, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2022; 57(1): 68. CrossRef
Anterior Approach for the Acetabular Fractures
Jae Youn Yoon, Jae-Woo Cho, Ji Wan Kim
Journal of the Korean Fracture Society.2019; 32(3): 157. CrossRef
Reduction Technique of Dome Impaction Using the Modified Stoppa Approach: A Technical Note
Ji Wan Kim, Yong Min Seo, Hyo-Seok Jang
Journal of the Korean Fracture Society.2017; 30(3): 131. CrossRef
Biological fixation of pelvic ring and acetabular fractures: a pilot study with anatomical validation
Abdelfattah Mohamed Fathy Saoud, Ahmed Mohamed Sallam, Ahmed Mohamed Morsey
Current Orthopaedic Practice.2017; 28(3): 303. CrossRef
Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef

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The Incidence of Venous Thromboembolism in Trauma Patients with Pelvic or Acetabular Fracture: Ji Wan Kim, Hyun Wook Chung, Young Chang Kim; J Korean Fract Soc 2012;25(4):250-256. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.250

Abstract PDF

PURPOSE
To evaluate the incidence of venous thromboembolism (VTE) in trauma patients with pelvic or acetabular fracture and determine high risk factors.
MATERIALS AND METHODS
Twenty-three patients who had a pelvic or acetabular fracture were enrolled between March 2011 and February 2012. All patients had mechanical and chemical prophylaxis and underwent deep vein thrombosis (DVT) computed tomography around 2 weeks after injury for evaluation of VTE. The relationships between VTE and each of sex, age, body mass index, injury severity score, intensive care unit stay, transfusion, operation time, coagulopathy, and associated injury were analyzed.
RESULTS
A total of 8 patients developed VTE (34.8%), of which 5 had DVT, 2 had pulmonary embolism (PE), and one had both DVT and PE. The group with a VTE risk score of 14 or more had a significantly higher incidence of VTE.
CONCLUSION
Careful attention is needed in management of patients with pelvic or acetabular fracture.

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Knowledge, Health Belief, and Preventive Behavioral Intention related to Venous Thromboembolism (VTE) of the Patients with Lower Limb Musculoskeletal System Disorders
Hye Jin Yang, Hee-Young Kang
The Journal of Korean Academic Society of Nursing Education.2013; 19(4): 531. CrossRef

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Bowel Entrapment by Fragments of Acetabular Fracture: A Case Report: Ji Wan Kim, Jung Jae Kim, Suk Kyung Hong, Kyu Hyuk Kyung, Jin Hee Kim; J Korean Fract Soc 2010;23(4):373-376. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.373

Abstract PDF: Abdominal injuries are common in patients with pelvic or acetabular fracture. However intestinal entrapment or perforation caused by fragments of a pelvic or acetabular fracture is rare and to date there has been no report of this occurring in Korea so far. As it is difficult to diagnose intestinal entrapment caused by fragments of pelvic or acetabular fracture, the entrapment therefore results in intestinal perforation, sepsis, and a high mortality rate in the absence of early detection. We present a case of intestinal entrapment and perforation caused by fragments of acetabular fracture as well as a literature review.

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Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures: Chong Kwan Kim, Jin Woo Jin, Jong Ho Yoon, Sung Won Jung, Jung Wook Peang; J Korean Fract Soc 2008;21(2):95-102. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.95

Abstract PDF

PURPOSE
To evaluate the usefulness of wire fixation in displaced acetabular fractures.
MATERIALS AND METHODS
From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases.
RESULTS
We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases.
CONCLUSION
The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.

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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef

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Combined Femoral and Sciatic Nerve Palsy Associated with Acetabular Fracture and Dislocation: A Case Report: Ki Chul Park, Kang Wook Kim, Young Ho Kim; J Korean Fract Soc 2005;18(3):341-344. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.341

Abstract PDF

Sciatic nerve palsy is the most common nerve injury associated with acetabular fracture and dislocation, but femoral nerve injury is known to be very rare because of relative protected position of nerve between the iliacus and psoas muscle, and as far as we know only one report was noted in English about combined femoral and sciatic nerve injury associated with acetabular fracture and dislocation, so we hereby report a case of combined femoral and sciatic nerve palsy associated with acetabular fracture and dislocation.

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Effects of Unilateral Sciatic Nerve Injury on Unaffected Hindlimb Muscles of Rats
Jin Il Kim, Myoung-Ae Choe
Journal of Korean Academy of Nursing.2009; 39(3): 393. CrossRef

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Surgical and Conservative Treatment of Acetabular Fractures: Chong Kwan Kim, Byung Woo Ahn, Saeng Guk Lee, Jae Ik Chung, Jin Woo Jin, Kwon Ho Kim, Kang Hoon Kim; J Korean Soc Fract 2003;16(3):309-318. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.309

Abstract PDF

PURPOSE
Fractures of the acetabulum remain a major challenge to the orthopedic surgeons. Although the operative treatment for the complex fractures is preferred, inaccurate reduction and then incongruity of the hip joint lead to serious complication such as premature osteoarthritis. We evaluated the results of surgical and conservative treatment for acetabular fractures.
MATERIALS AND METHODS
From January 1996 to March 2001, we reviewed 55 cases retrospectively. Posterior wall fracture (13 cases) was the most common by Letournel's classification and followed by both column fracture (10 cases). Causes of injuries included 41 cases of traffic accident and 8 cases of falling down. We divided the cases into an operation group (28 cases) and conservative group (27 cases) and evaluated the results as excellent, good, fair or poor according to Matta's clinical and radiological grade criteria.
RESULTS
Anatomical or satisfactory reduction was obtained in 22 cases of operative group and clinical results were excellent in 7 cases, good in 13 cases. Conservative group revealed excellent and good clinical results in 15 of 27 cases.
CONCLUSION
In cases of the displaced complex fractures, posterior wall fracture with instability and displaced fractures involving the weight bearing dome of the acetabulum, open reduction and internal fixation after accurate evaluation of the fracture pattern could allow earlier ROM exercise and have the result in better prognosis.

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Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction
Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo
The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef

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Total Hip Arthroplasty Following Acetabular Fracture: Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Dong Oh Ko, Jin Woong Yi; J Korean Soc Fract 2003;16(2):121-127. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.121

Abstract PDF: PURPOSE
We evaluated the results of secondary total hip arthroplasty (THA) after acetabular fracture. MATERIAL & METHODS: Twenty cases of THA were performed to treat acetabular fracture as a secondary treatment after conservative management (6 cases) or internal fixation (14 cases). The mean follow up period was 5 years 2 months. The cause of secondary THA was post traumatic arthritis in 15 hips and osteonecrosis of the femoral head in 5. Cementless acetabular cup was used in 18 cases and cemented in 2 cases. Cementless femoral component was used in 18 cases and cemented in 2 cases. Serial Harris hip score (HHS), pain, limb length discrepancy and radiographs were evaluated.
RESULTS
HHS improved from 57 points to 91 points. Osteolysis in the acetabular component occurred in 2 cases and 5 cases in the femoral component. Loosening occurred in 2 cases of cemented acetabular components and 1 case in the femoral component. In this study, 3 cases (15%) required revision of the acetabular component and 2 cases (10%) of the femoral component.
CONCLUSION
The clinical results of THA after acetabular fracture was inferior to that of conventional arthroplasty. The secure cementless acetabular fixation with proper bone grafting is mandatory to improve the survival of acetabular component.

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Assessment of Surgical Treatment of Acetabular Fracture after Minimum Five-year Follow-up: Do Hyun Moon, Jang Seok Choi, Ki Ju Park, Jong Min Yun; J Korean Soc Fract 2002;15(3):342-348. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.342

Abstract PDF: PURPOSE
To review the clinical and radiographic results of operative treatment of acetabular fractures for which there were minimum five-year follow-up.
MATERIALS AND METHODS
We reviewed 22 acetabular fracture cases that had been treated operatively from March 1993 to July 1996. Each of the patients had been followed for a minimum five-year. The radiographic results were classified by Matta 's criteria and the clinical results were analyzed according to d 'Aubigne and Postel 's criteria.
RESULTS
Satisfactory reduction were obtained in 18 hips (81.8%), 14 and 13 hips of which were included in good or excellent categories of roentgenographic and clinical results respectively. Overall radiographic results for 17 hips (77.3%) at the one-year follow-up and 14 hips (63.6%) at the minimum five-year follow-up were excellent or good. According to clinical criteria, 16 hips (72.7%) at the one-year follow-up and 13 hips (59.1%) at the minimum five-year follow-up were classified as excellent or good.
CONCLUSION
Folow-up roentgenographic and clinical results were good or excellent in satisfactory reduction group. Threrefore the accuracy of reduction is an important prognostic factor in acetabular fracture. The results were worse at the minimum five-year follow-up than at the one-year follow-up. Late-postoperative complication is expected to increase as time passes.

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Tibial Condyle Fracture Treated by Osteosynthesis with a Buttress Plate: Duck Yun Cho, Sung Jin Kim, Gun Yeon, Young Yoo Kim, Sung Joon Im, Chun Hee Won; J Korean Soc Fract 2000;13(4):868-876. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.868

Abstract PDF: PURPOSE
We analyzed the anatomical results of operative treatment in acetabular fractures according to fracture pattern and surgeon's experience. MATERIAL AND METHODS: From December, 1993 to December, 1999, 100 cases of acetabular fractures operated by single surgeon were analyzed. Fracture configuration was classified by Letournel's method. The anatomical results were classified by Matt' s criteria and Claude Martimeau score.
RESULTS
There were 36 elementary fractures(anterior column type: 4 cases, posterior wall type: 29 cases, transverse type: 3 cases) and 64 complex fractures(posterior wall and posterior column type: 4 cases, anterior and posterior hemitransverse type: 8 cases, transverse and posterior wall type: 16 cases, T type: 6 cases, both column type: 30 cases). According to Matta's criteria, all elementary fractures were seen anatomic or satisfactory results however, eleven cases of combined fracture were seen unsatisfactory results. Mean Claude Martimbeau's score was 6.1 point. Elementary fracture was 7.5 point and combined fracture was 5.4 point. Both column fracture was 4.4 point and it was the lowest point among the fractures. In both column fracture, the improvement of surgeon's skill made more good anatomical results. There were four cases of infection and 2 cases of nerve injury.
CONCLUSION
In operative treatment of acetabular fractures, complexity of fracture demands more appropriate surgical approach and skillful surgeon,

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Operative Treatment of Acetabular Fractures: Jong Oh Kim, Yo Hun Yun, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Hyoung Jin Jeong, Yi Kyoung Shin; J Korean Soc Fract 2000;13(4):761-770. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.761

Abstract PDF: PURPOSE
We reviewed 47 cases of acetabular fractures which was treated operatively, to review the clinical results of operative treatment of acetabular fractures considering the experience of a surgeon, to assess the relationship between the quality of the operative reduction and the clinical results.
MATERIALS AND METHODS
We reviewed 47 cases of acetabular fractures which was treated operatively from September 1993 to December 1999 and follow up more than 1 year. And we analyzed retrospectively the data in the aspect of the relationships between the radiologic evaluation of the reduction and the clinical results, and we reviewed the initial 20 cases as a group I and the later 27 cases as a group II to compare the differences of clinical results of the two groups.
RESULTS
In the accuracy of reduction, anatomical reductions were 4 hips in the group I and 13 in the group II, satisfactory 7 hips in the group I and 9 hips in the group II, unsatisfactory 9 hips in the group I and 5 hips in the group II. We assess the over-all clinical result with the criteria of Merle d'Aubigne and Postel. In the group I, 20 hips, the clinical result was excellent for 3 hips(15%), good for 6 hips(30%), fair for 5 hips(25%), and poor for 6(30%) hips. In the group II, 27 hips, the clinical result was excellent for 11 hips(41%), good for 8 hips(30%), fair for 5 hips(18%), and poor for 3(11%).
CONCLUSION
The accuracy of reduction was closely related to the clinical results. And the more a surgeon getting experienced, the better accurate reduction and clinical results were possible.

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Anatomical Results According to Fracture Pattern after Surgical Treatment of Acetabular Fractures: Kyu Hyun Yang, Dae Yong Han, Seong Jin Park, Jae Min Jung; J Korean Soc Fract 2000;13(4):754-760. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.754

Abstract PDF

PURPOSE
We analyzed the anatomical results of operative treatment in acetabular fractures according to fracture pattern and surgeon's experience. MATERIAL AND METHODS: From December, 1993 to December, 1999, 100 cases of acetabular fractures operated by single surgeon were analyzed. Fracture configuration was classified by Letournel's method. The anatomical results were classified by Matt' s criteria and Claude Martimeau score.
RESULTS
There were 36 elementary fractures(anterior column type: 4 cases, posterior wall type: 29 cases, transverse type: 3 cases) and 64 complex fractures(posterior wall and posterior column type: 4 cases, anterior and posterior hemitransverse type: 8 cases, transverse and posterior wall type: 16 cases, T type: 6 cases, both column type: 30 cases). According to Matta's criteria, all elementary fractures were seen anatomic or satisfactory results however, eleven cases of combined fracture were seen unsatisfactory results. Mean Claude Martimbeau's score was 6.1 point. Elementary fracture was 7.5 point and combined fracture was 5.4 point. Both column fracture was 4.4 point and it was the lowest point among the fractures. In both column fracture, the improvement of surgeon's skill made more good anatomical results. There were four cases of infection and 2 cases of nerve injury.
CONCLUSION
In operative treatment of acetabular fractures, complexity of fracture demands more appropriate surgical approach and skillful surgeon,

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Surgical Treatment of Posterior Wall Fractures of the Acetabulum
Young-Soo Byun, Se-Ang Chang, Young-Ho Cho, Dae-Hee Hwang, Sung-Rak Lee, Sang-Hee Kim
Journal of the Korean Fracture Society.2007; 20(2): 123. CrossRef

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Significance of Anatomic Reduction in Acetabular Fracture: Sung Kon Kim, Jung Ho Park, Jong Wung Park, Joon Seok Hong, Jae Hun Kim; J Korean Soc Fract 2000;13(4):724-732. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.724

Abstract PDF

PURPOSE
The purpose of operative treatment in acetabular fracture is to restore anatomically the disrupted joint surface and prevent post-traumatic arthritis. We analysed the relationship between the types of the fracture, its location, reduction state with the development of post-traumatic arthritis and hip joint function in postoperative period.
METHOD
& MATERIAL: A clinical analysis was performed on 14 patients, excluding patients with anterior & posterior wall fracture, with displaced acetabular fracture who had been treated by open reduction and internal fixation. All patients had been followed for minimum 1 year in our department from May 1989, to February 1999.
RESULTS
The type of acetabular fracture was not correlated statistically with posttraumatic arthritis and Harris hip score. The reduction state of acetabular fracture was significantly correlated with post-traumatic arthritis and Harris hip score. The antomic location of acetabular fracture was not correlated statistically with post-traumatic arthritis but correlated with Harris hip score.
CONCLUSION
Anatomic reduction is more significant factor in postoperative outcome of acetabular fracture than the type of fracture and the anatomic location of fracture.

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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef
Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures
Chong-Kwan Kim, Jin-Woo Jin, Jong-Ho Yoon, Sung-Won Jung, Jung-Wook Peang
Journal of the Korean Fracture Society.2008; 21(2): 95. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim
Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef

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The Surgical Treatment of displaced Acetabular Fracture: Sang Hong Lee, Kyung Ho Kim, Pyong Ju; J Korean Soc Fract 2000;13(3):454-462. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.454

Abstract PDF: PURPOSE
To analysis clinical and radiological results of operative treatment of displaced acetabular fractures and establish the guideline for the operative treatment of displaced acetabular fracture with the analysis of the clinical and radiological results.
MATERIALS AND METHODS
A clinical analysis was performed on 36 patients with displaced acetabular fractures who had been operated on and followed for minimum 1 year period from January 1993 to December 1998. Clinical outcome was analyzed clinically by Harris hip scoring system and radiologically by Matta's roentgenographic grading system.
RESULTS
According to Letournel's classification, we had 25 elementary fractures(69%) and 12 associated fracture(31%). Among the elementary fractures, the posterior wall fracture was the most common type(17 cases, 47%) and both column fracture was the most common type among associated fractures(5 cases, 11%). Surgical approaches were 22 Kocher-Langenbeck, 8 extended iliofemoral, 3 triradiate transtrochanteric, 3 ilioinguinal. The mean duration of follow up after the operation was 2.2 years (range, 1 to 7 years). Among thirty six patients who had followed up more than one year, the satisfactory results were achieved in 27 cases (75%) on clinical grade and 26 cases (72%) on radiographic grade. The complications were developed in 20 cases out of 36 cases including posttraumatic arthritis 7 cases, heterotopic ossification 4 cases.
CONCLUSION
In the majority of the displaced acetabular fractures, accurate open reduction and internal fixation was recommended. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result according to our study. Therefore in the surgical treatment of the acetabuluar fractures, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixation device.

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Treatment of Acetabular Fracture with Wire: Chang Soo Kang, Dong Hwa Woo, Doo Hwan Oh; J Korean Soc Fract 2000;13(3):432-439. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.432

Abstract PDF: PURPOSE
To evaluate the clinical and radiological results of wire fixation for acetabular fracture and its merits.
MATERIALS AND METHODS
From 1996 Jan. to 1998 Dec., 18 cases of being fixed by wire among 42 cases who being treated by surgical method were analyzed. We evaluated these cases after a mean follow up of 2.1 years. The fixation was done by wires in 11 cases, wires with plate in 3 cases and wires with screw in 4 cases.
RESULTS
According to Epstein's criteria, favorable results were achieved in 15 cases(83.3%) on clinical grade and 14 cases(77.7%) on radiographic grade.
CONCLUSION
The results of this study suggest that open reduction and internal fixation with wire is preferable method that can permit early ambulation, decrease postoperative complication and achieve firm fixation, comparing with open reduction and internal fixation with plate and screws, in treatment of displaced acetabular fractures.

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Fixation of Complex Acetabular Fractures Using Cerclage Cable Grip System(DALL-MILES): Poong Taek Kim, Joo Chul Ihn, Gun Wook Park, Yung Ook Choi, Chan Sig Park; J Korean Soc Fract 1999;12(4):761-766. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.761

Abstract PDF: From 1996, in the 13 fractures of the acetabulum surgically treated in Kyung Pook National Hospital and Sae-Myung Orthopedics, cerclage grip system(DALL-MILES) have been used as reduction and fixation tool. Cerclage cable inferted through the greater sciatic notch to a point just cephalad to the anterior inferior spine was greatly helpful for both reduction and internal fixation of thirteen complex acetabular fractures. This technique is especially useful when the fracture line extend into the greater sciatic notch. This is true of high posterior column fractures that extend up into the upper part of the notch, transverse fractures that have an anterior or posterior limb that is high, and both column fractures through ilioinguinal approach with T- extension. Reduction was achieved to within 3mm in 11 cases and 6mm in 2 cases. This reduction was maintained until nuion. The technique may contribute to fracture stabilization, but supplementary fixation was added in 12 patients with curved reconstruction plate over pelvic brim and posterior column in 1 patient.

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The Operative Treatment of Acetabular Fracture: Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee; J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.212

Abstract PDF: PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type. MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.

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Management of Acetabular Fracture: Myung Sik Park, Hyung Ju Park; J Korean Soc Fract 1999;12(1):47-55. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.47

Abstract PDF

Acetabular fractures are relatively uncommon, but frequency is becoming increasingly with the increase of automobile accident. Undisplaced acetabular fractures have a good prognosis, but major displaced acetabular fractures have always given rise to difficulty and have a problem if fractures are not accurately evaluated, classified and reduced anatomically. The priciples of treatment are to restore the fractured acetabulm to its normal anatomy, to maintain and restore the function and accordingly early joint motion to promote healing and to prevent joint adhesion. However, the treatment of displaced fracture of acetabulum has been controversal. Judet, Pennal and Matta advocated open reduction and internal fixation for displaced fracture of acetavbulum. But, Watson Jones and Crenshaw reported that closed reduciton such as traction was used, good result could be obtained. The authors studied the sex and age distribution, classification according to roentgenographic findings, associated injuries, methods of treatment and prognosis among 67 patients who were admitted to the department of Orthopedic Sugery of Chonbuk National University Hospital under diagnosis of acetabular fracture and we evaluate the usefulness of spring plate for posterior wall fracture of acetabulum. The results were as follows, 1. The prevalant age was fourth decade and the cause of injury was traffic accident in the majority. The most common type of fracture was posterior wall fracture and the second was transverse fracture by Letournel classification 2. The complications were posttraumatic arthritis in 21%, ectopic ossification, peroneal nerve palsy and wound infection. The prognosis of the total hip arthroplasty for complicated traumatic arthritis was relatively poor than others. 3. Satisfactory results by clinical criteria(by Postel) of operative treatment were 71% and conservative treatment 46%. In the majority of displaced acetabular fractures, open reduction and internal fixation was recommended. If surgery is attempted, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach fixation device. We can make a satisfactory results by the treatment with spring plates in the comminuted posterior column fractures or posteior wall fractures that was difficulty in the treatment by simple plates.

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Spectroscopic studies and evanescent optical fibre wave sensing of Cu2+ based on activated mesostructured silica matrix
Othman Belhadj Miled, Clément Sanchez, Jacques Livage
Journal of Materials Science.2005; 40(17): 4523. CrossRef

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Surgical Treatment of Displaced Acetabular Fractures - focused on Complications after open reduction -: Chung Nam Kang, Jong Oh Kim, Kong Uk Kim, Yeong Do Koh, Byeong Geun Kim; J Korean Soc Fract 1998;11(3):477-486. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.477

Abstract PDF: Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. The results had been proved to be successful after anatomical reduction and stable internal fixation. The purpose of this study is to analyze the clinical results and complications of open reduction of the displaced acetabular fractures to minimize the complications, and to present suggestions for the treatment of these fractures. We reviewed our experience with 23 displaced acetabular fractures which had been treated by open reduction to evaluate the clinical results and complications. The results were as follows; 1. The most common type of elementary fractures was posterior wall fractures according to Letournel's classification. 2. Excellent or good results were obtained in 88% among the satisfactory reduction group, and it means that accurate reduction was the most reliable factors contributing to successful clinical outcomes. 3. Complications were 1 deep infection, 2 ectopic bone formation, 1 intraarticular hardware, and 1 chondrolysis. 4. In the treatment of displaced acetabular fractures, careful initial assessment using radiograph, angiogram and 3-D CT, appropriate selection of surgical approach and accurate surgical clinical outcome and minimize the complication rate.

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Treatment of Acetabular Fractures -Comparison of Conservative Treatment and Surgical Treatment According to AO Comprehensive Classification-: Chang Hyuk choi, Koing Woo Kwun, shin Kun Kim, Sang Wook Lee, seung Hee Kim; J Korean Soc Fract 1998;11(2):288-295. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.288

Abstract PDF: Acetabular fracture is a severe injury associated with other body injuries. they result in permanent disability due to management difficulty and its complications such as traumatic arthritis, avascular necrosis of femoral head, etc.. In order to restore excellent function of hip joint, anatomic reduction and secure internal fixation followed by early mobilization are neccessary. We analysed 21 patients who were diagnosed as type A1 acetabular fracture from Jan. of 1991 to Dec. of 1996, and compared the functional results of conservative treatment method with that of surgical treatment method. The results were as follows. 1. Conservative management was done at 8 cases, and surgical management was done at 13 cases with open reduction and internal fixation. 2. The functional result by Goodwin criteria was all satisfactory in conservative reatment method and 12 cases(92%) in surgical treatment method. 3. Associated injuries were found in 18 cases, among them pelvic bone fracture was the most common fractured site and knee ligament injury was the most common soft tissue injury. 4. In the cases of larger acetabular fragment or in the presence of associated injury and instability after closed reduction, faster rehabilitation was achieved by starting early range of motion exercise and weight-bearing after surgical treatment than classical conservative treatment.

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Radiological Findings and Classification of the Acetabular Fractures: Woo Shin Cho; J Korean Soc Fract 1997;10(3):458-464. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.458

Abstract PDF: Correct classification based on the accurate radiological evaluation is the keypoint in proper management of the acetabular fracture. Interpretation of the radiologic features of the acetabular fracture requires understanding of the relationship between radiologic landmarks and anatomic structures composing acetabulum. The standard radiographic views include acetabular A-P, iliac oblique and obturator oblique views. CT is mandatory for evaluation and provides more accurate informations, such as size and location of the fragment, joint impaction, intraarticular fragment, comminution, dislocation of the femoral head and sacroiliac joint involvement. Combined interpretation of the standard radiographic views and CT is essential. Tomography and 3-D CT provide additional information. Two representative classification systems of the acetabular fracture are Judet and Leteurnal classification and comprehensive classification of AO. Judet and Letpurnal focused on anatomic two columns and two walls, and devided the acetabular fracture into five elementary and five associated fracture types. The elementary fracture types are basically two part and the associated fractures are combination of at least two elementary types and so, they are three or four part fractures. Comprehensive classification system is based on Judet and Letournal classification and follows skeletal AO classification system. It is apprehensive, logic, universal and easy to computerize. Besides, it shows fracture personality which is important prognostic factors. Type A represnets single wall or column fractures, type B tran,iverse oriented fractures, and type C complete articular fracture, namely floating acetaoulum. The sequence in groups under the type is correlated with the prognosis but not always in types.

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Cable Fixation Method for Displaced Acetabular Fracture: Chang Soo Kang, Byung Woo Min, Kwang Soon Song, Chul Hyung Kang, Jong Wan Park; J Korean Soc Fract 1996;9(3):574-582. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.574

Abstract PDF

The operative treatment of displaced acetabular fracture has become the preferred method than conservative treatment. Displaced acetabular fracture occurs primarily in young adult involved in high energy trauma and it can lead to some degree of permanent disability. The aim of treatment must be the restoration of hip function which require accurate anatomical reduction and firm fixation followed by early exercise. The complicated anatomy of the region, and unsatisfactory fixation to cancellous bone, and unnecessary wide dissection of the soft tissue for plate and screw fixation contribute to clinical end results of varying success. The wire loop which was previously reported by our department as a successful method of fixation has now been developed to cable fixation that can be easily adjusted to the irregular surface of acetabulum and get more firm fixation. A clinical analysis was performed on 14 patients with displaced unstable acetabular fracture who had been fixed by cable and followed for minimum 1 year period at our department from June 1993 to June 1994. The results were follows; 1. According to Letournels classification, there were most common(9 cases:64.4%) in both column fracture, 3 cases(21.4%) in T shaped fracture, 1 case(7.1%) in transverse fracture, and 1 case(7.1%) in transverse and posterior wall fracture. 2. The satisfactory result was achieved in 12 cases(85.7%) on clinical grade and 12 cases(85.7%) on radiographic grade according to Epstein criteria. 3. The complication were developed in 3 cases(21.4%) out of 14 cases, such as posttraumatic arthritis in 2 cases and transient sciatic nerve palsy in 1 case. 4. Cable fixation provides a more secure and easy fixation and require a narrower exposure than a plate fixation.

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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures
Chong-Kwan Kim, Jin-Woo Jin, Jong-Ho Yoon, Sung-Won Jung, Jung-Wook Peang
Journal of the Korean Fracture Society.2008; 21(2): 95. CrossRef

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Surgical Treatment for Posterior Fracture-Dislocations of the Hip with Fracture of Acetabulum: Byung Woo Min, Chang Soo Kang, Young Sik Pyun, Kwang Soon Song, Chul Hyung Kang, Sang Hak Lee; J Korean Soc Fract 1994;7(2):530-537. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.530

Abstract PDF

Thirty-one posterior fracture-dislocations of hip with fracture of acetabulum were followed from 6 months to 84 months(average, 23.3 months). The patientsages ranged from 19 to 58 years(average, 35.4 years). All had primary attempt at closed reduction with subsequent open reduction. Satisfactory results were obtained in 87% of all patients. Complications included partial sciatic nerve palsy(1 case), myositis ossificans(2 cases), osteoarthritis(3 case), recurrent dislocation(1 case) and infections(2 cases). This survey was undertaken to assess the results of a certain method of treament, and in the hope of contributing further information on this subject.

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Complications in Patients with Acetabular Fractures Treated Surgically
Byung Woo Min, Kyung-Jae Lee
Journal of the Korean Fracture Society.2008; 21(4): 341. CrossRef
Surgical Treatment of Posterior Wall Fractures of the Acetabulum
Young-Soo Byun, Se-Ang Chang, Young-Ho Cho, Dae-Hee Hwang, Sung-Rak Lee, Sang-Hee Kim
Journal of the Korean Fracture Society.2007; 20(2): 123. CrossRef

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Surgical Treatment of Acetabular Fracture: Sung Kon Kim, Seung Woo Suh; J Korean Soc Fract 1994;7(2):422-430. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.422

Abstract PDF

Acetabular fracture results from high-enegy trauma that cause considerable displacement of the fracture fragments as well as to articular surface of the acetabulum. The goal of surgical treatment is to prevent post-traumatic arthritis and avascular necrosis of femoral head by reconstructing the articular surface accurately and restoring the contact areas between the acetabular and femoral head. We analyzed 15 patients who were treated with surgical method at Korea University Ansan Hospital from May 1989 to July, 1992 and followed up more than 1 year. The results were as follows: 1. The most common type was posterior wall fracture in 5 cases(33.3%), transverse fracture in 4 cases(26.7%), both column fracture in 4 cases(26.7), anterior column fracture in 2 cases(13.3%) in sequeuce according to Letournel classification. 2. The most common cause of injury was traffic accident in 13 cases(86.6%), and 2 cases(13.4%) were passengers. 3. There were 9 cases(60.0%)operated within 7th day after injury, 4 cases(26.7%) between the 7th day and 14th day, 2 cases(13.3fo)at the 21st day. 4. The employed surgical approaches were the extended ilio-femoral approach in 7cases(46.7%), the Hocker-Langenbeck approach in 6 cases(40.0%), the ilioinguinal approach in 2 cases(13.3%). 5. The result of treatment was satisfactory in 13 cases(87.7%) and the complications were post traumatic arthritis in 2 cases(15.4%), ectopic ossification in 1 case(6.7%), and avascular necros of femoral head in 0 case.

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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef

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Management of Acetabular Fracture: Kwang Jin Rhee, Jyun Kyu Lee, Chan Hee Park, Ho Suk Lee, Kyoung Tai Kim; J Korean Soc Fract 1994;7(1):137-143. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.137

Abstract PDF: Acetabulum consisting of the hip joint is the most important weight bearing portion in the lower extremity But if fractures of acetabulum are not accurately evaluated, classified, and reduced anatomically, major sequalae and complication are frequently developed. Because of complicated anatomy, difficulty with surgical exposure, frequent associated injury, the treat ment of acetabular fractures between conservative and surgical methods is still controversal. We studied roentgenographic finding, associated inlury, method of treatment and result of treatment. We reviewed forty cases of acetabular fracture from May 1985 to July 1993. The results was as follows; 1. The pervalent age was from second decade to forth decade. 2. We classified 40 cases by Letournel classification. The most common type was posterior wall fracture, the second was anterior column fracture. 3. Most common associated injury was pelvic bone fractures. 4. Surgical approaches were decided by the fracture type and duration from injury to operation. 5. In nonoperative treatment group, 73.3% of cases were excellent and good result, and in operative treatment group 88.0% of cases were excellent and good result. 6. The complications were occured in 12 cases(48.0%) of 25 cases of operative reatment group.

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Operative treatment for acetabular fractures: Heui Jeon Park, Jae In Ahn, Hwa Seop Yim; J Korean Soc Fract 1991;4(2):258-266. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.258

Abstract PDF: No abstract available.

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