The acetabulum is a socket in the hip bone that holds the femoral head, forming the hip joint. Acetabular fractures are rare but serious injuries that require surgery. Treatment involves putting bone fragments together and fixing them in place using screws, pins, plates, and wires. Recovery is gradual, and some people may develop arthritis.
The acetabulum is a rounded depression in the hip bone. It forms a socket that holds the ball-shaped head of the femur, or thighbone, allowing it to rotate fairly freely. Together, the acetabulum and the femoral head form what is known as the hip joint. Acetabular fractures are rare but serious injuries and usually require surgery. Acetabulum is a Latin word meaning a small cup of vinegar.
A smooth tissue known as cartilage lines the walls of the acetabulum, except at the bottom edge, where there is a space in the socket called the acetabular notch. The deepest part of the socket is known as the acetabular fossa. It has no cartilage and does not participate in joint movement. Sometimes, as part of a condition known as developmental dysplasia of the hip, a baby can be born with an abnormally shaped femoral or acetabulum head, but the outlook is bright if treatment starts early, using methods that may include a sling, a positioning cast, or surgery.
Fractures of the acetabulum usually occur when the ball-shaped head of the femur is lifted through the socket during a fall or an automobile accident. Symptoms of severe pain and inability to walk typically follow, and x-rays of the pelvis and computed tomography (CT) scans may be used to diagnose the problem. This type of fracture is difficult to treat because the site is awkward to reach and is also close to important nerves and blood vessels, the bladder, and intestines.
Surgery to repair acetabulum fractures first involves putting the bone fragments together and fixing them in place using screws, pins, plates, and wires. Because there is a significant amount of bleeding involved in this type of injury, surgery is usually done after several days have passed, to allow for clotting sooner. Pain relief is provided and the patient can be placed in traction to prevent further damage from occurring.
Recovery is gradual after surgery for an acetabular fracture, with the use of crutches for at least the first two months. It is likely that the nerves were damaged to some extent, either during the initial injury or later in the surgery. Any resulting reduced sensation or reduced movement in a limb can take up to 18 months to improve, and a full recovery isn’t guaranteed, although most people do feel some improvement. Some people will develop arthritis, due to the irreversible and damaging effects of the injury on the cartilage lining the socket.
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