Introduction
Background
Most acetabular fractures occur in the setting of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. Blunt force is exerted on the femur, passes through the femoral head, and is transferred to the acetabulum. The direction and magnitude of the force, as well as the position of the femoral head, determine the pattern of acetabular injury. The determination of the pattern of injury is key to the classification of an acetabular fracture. Once the acetabular fracture is classified, appropriate therapy may be planned and implemented.1,2,3,4,5
Acetabular fracture orientation with a computed tomography (CT) scan. A CT scan of the left acetabulum obtained at the level of the dome shows that transverse-type acetabular fractures have a vertical (sagittal) orientation. Column-type fractures have a horizontal (coronal) orientation.
Acetabular fracture orientation with a computed tomography (CT) scan. A CT scan of the left midacetabulum shows that wall fractures have an oblique orientation.
Related eMedicine topics:
Acetabulum Fractures (from Orthopedic Surgery)
Pelvic Fractures
Pathophysiology
One function of the acetabulum is to provide a means of transferring weight-bearing forces from the appendicular skeleton to the axial skeleton via the acetabulum's articulation with the femoral head. The femoral head also transfers high-energy forces to the acetabulum in the setting of trauma. The pattern of acetabular injury is determined by the position of the femoral head at the time of the traumatic event. When the femoral head is rotated internally, the force is transferred to the posterior column. When the femoral head is rotated externally, the force is directed toward the anterior column. If the femoral head is adducted, the force is transmitted to the acetabular roof; if it is abducted, the force is directed inferiorly.
The direction of the force also determines which part of the acetabulum is injured. An anterior force applied to the femoral head is transmitted to the posterior wall and column. Conversely, a posterior force affects the anterior wall and column. A force to the lateral aspect of the femoral head is directed toward the medial wall of the acetabulum, often resulting in transverse acetabular fractures.
Frequency
United States
Table 1. Relative Frequency of Acetabular Fracture Types
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Table
| Fracture Type | Letournel 6 * (%) | Matta 7 ** (%) | Dakin et al 8 † (%) |
|---|---|---|---|
| Both-column | 27.9 | 33.3 | 14.1 |
| Transverse with posterior wall | 20.6 | 23.5 | 35.3 |
| Posterior wall | 22.4 | 8.6 | 12.9 |
| T-shaped | 5.3 | 12.2 | 3.5 |
| Transverse | 3.7 | 3.5 | 8.2 |
| Anterior column | 3.9 | 4.7 | 1.2 |
| Anterior column with posterior hemitransverse | 8.8 | 5.9 | 3.5 |
| Posterior column with posterior wall | 3.5 | 3.9 | 18.8 |
| Posterior column | 2.3 | 3.1 | 1.2 |
| Anterior wall | 1.6 | 1.2 | 1.2 |
| Fracture Type | Letournel 6 * (%) | Matta 7 ** (%) | Dakin et al 8 † (%) |
|---|---|---|---|
| Both-column | 27.9 | 33.3 | 14.1 |
| Transverse with posterior wall | 20.6 | 23.5 | 35.3 |
| Posterior wall | 22.4 | 8.6 | 12.9 |
| T-shaped | 5.3 | 12.2 | 3.5 |
| Transverse | 3.7 | 3.5 | 8.2 |
| Anterior column | 3.9 | 4.7 | 1.2 |
| Anterior column with posterior hemitransverse | 8.8 | 5.9 | 3.5 |
| Posterior column with posterior wall | 3.5 | 3.9 | 18.8 |
| Posterior column | 2.3 | 3.1 | 1.2 |
| Anterior wall | 1.6 | 1.2 | 1.2 |
* n = 567.
** n = 255.
† n = 85.
Mortality/Morbidity
- Associated injuries
- Significant trauma is required to cause a fracture of the acetabulum. Therefore, acetabular fractures are most often observed in the setting of major trauma, in which injuries elsewhere in the body are common.
- Intracranial, spinal, intrathoracic, and intra-abdominal injuries often are observed in conjunction with acetabular fractures.
- Pelvic ring and extremity fractures also are common in patients with acetabular fractures.
- Bladder injury and clinically significant pelvic hemorrhage are not routinely observed in the setting of acetabular fracture unless a concomitant pelvic ring injury also is present.
- Complications of acetabular fracture include the following:
- Immediate posttraumatic complications include injuries to the sciatic,9 femoral, or superior gluteal nerves.
- Immediate postsurgical complications include nerve injuries, such as sciatic,9 femoral, and superior gluteal nerve injuries; wound infection; and thromboembolic disease.
- Late complications include heterotopic ossification,10 osteonecrosis (avascular necrosis) of the femoral head or acetabular fracture fragment, chondrolysis, posttraumatic osteoarthritis, and acetabular implant failure.
Age
Elderly patients and persons with osteoporosis may occasionally have an acetabular fracture as a result of low-energy trauma, such as a fall from a standing height.
Anatomy
Lateral view of the left acetabulum. The left
femur has been removed. The articular surface of the acetabulum
is in the shape of an inverted horseshoe (outlined in red). The
anterior column of the acetabulum includes most of the iliac
wing, the anterior acetabulum, and the superior pubic ramus.
The posterior column begins at the sciatic notch and includes
the posterior portion of the acetabulum and the
ischium.
Anteroposterior view of the pelvis. The left
femur has been removed for illustration purposes. The
iliopectineal, or iliopubic, line is an important landmark for
examining the anterior column of the acetabulum. The
ilioischial line demarcates the medial border of the posterior
column. The posterior wall of the acetabulum is larger and
projects more laterally than does the anterior
wall.
Left obturator oblique view of the pelvis. The
left obturator ring is seen en face. The anterior column and
posterior wall of the left acetabulum are profiled in this
position.
Left iliac oblique view of the pelvis. The left
iliac wing is demonstrated en face. The left posterior column
and the anterior wall are seen in profile.
Acetabular fracture classification system. Judet
and colleagues (1964) described the classification scheme that
is most commonly used today. Of the 10 types, 5 are elementary
fractures (top row), and 5 are associated fractures (bottom
row). Elementary types involve 1 primary fracture
plane. Associated types involve more than 1 fracture
plane.
Gross anatomy
The acetabulum is formed from 3 ossification centers; the ilium, ischium, and pubis each contribute to its development at the triradiate cartilage. The important anatomic components of the acetabulum are the columns, walls, dome, and quadrilateral plate. The acetabulum is divided into 2 columns: anterior and posterior. The 2 columns are described as having the shape of an inverted Y, or of the Greek letter lambda (l).
The anterior column is the larger of the 2 columns. It begins at the iliac wing and extends down the anterior portion of the acetabulum to incorporate the superior pubic ramus. The posterior column begins at the sciatic notch and extends down the posterior acetabulum into the ischium. Both columns are attached to the axial skeleton by the sciatic buttress, which connects the acetabulum to the sacroiliac joint. The column concept is appreciated more easily on the lateral view (see Image 1).
The posterior wall is larger than the anterior wall. The lateral portion of either wall is termed the acetabular rim. The walls help to stabilize the hip joint. The quadrilateral plate is the medial wall of the acetabulum. The dome of the acetabulum is the superior aspect that carries most of the weight-bearing forces. The obturator ring is an important landmark because some acetabular fractures spare the ring, whereas others disrupt it. The iliac wing is considered part of the anterior column.
Radiographic anatomy
The anteroposterior (AP) view of the pelvis is the primary tool for radiographic evaluation of the acetabulum (see Images 2-3). The iliopectineal, or iliopubic, line is the radiographic landmark for the anterior column. It begins at the sciatic notch and travels along the superior pubic ramus to the symphysis pubis. The ilioischial line demarcates the posterior column. It also begins at the sciatic notch, coursing inferiorly to the medial border of the ischium. The ilioischial line should pass through the acetabular teardrop. If it does not overlap the teardrop, the ilioischial line and, thus, the posterior column are disrupted.
The iliac wing is considered to be part of the anterior column. An iliac wing fracture in the setting of an acetabular injury indicates anterior column involvement. An iliac oblique radiograph provides a better view of the iliac wing. The posterior wall of the acetabulum is more visible than the anterior wall on the AP view because of its more lateral position. The anterior wall may be difficult to appreciate on the AP view. The obturator oblique view better depicts the posterior wall, and the iliac oblique view better depicts the anterior wall. The integrity of the obturator ring is an important feature to recognize. Certain fracture patterns (such as those of column and T-shaped fractures) characteristically include fractures through the obturator ring.
The oblique, or Judet, views of the pelvis are named relative to the side of interest (see Images 4-5). For example, if the acetabular fracture is on the left side, the views are named with reference to the left side. The left posterior oblique radiograph displays the iliac wing en face; therefore, this view is termed the left iliac oblique view. The right posterior oblique radiograph shows the obturator ring en face; therefore, this view is the left obturator oblique view. The iliac oblique view clearly demonstrates the iliac wing, sciatic notch, and ischial spine. In addition, the posterior column and anterior wall of the acetabulum are seen in profile. The obturator oblique radiograph provides the best depiction of the obturator ring and shows the anterior column and posterior wall in profile.
Presentation
Fractures of the acetabulum are most commonly classified according to the system described by Judet and colleagues.11 The system is based on the orientation of the fractures and the structures involved. In this system, the orientation of the fracture is based on its depiction on a lateral view of the acetabulum. In order to arrive at the correct classification, AP and oblique (Judet) radiographs of the pelvis are obtained and analyzed. Some authors have questioned the necessity of oblique views of the pelvis in the age of multidetector CT scanning.12 Harris and colleagues have proposed a new classification system based on the multidetector CT scan appearance.13,14 Other authors have defended the utility of the standard radiographic series in the evaluation of acetabular fractures.15 The Judet system will be presented in the remainder of this article.16
Acetabular fracture classification system. Judet and colleagues (1964) described the classification scheme that is most commonly used today. Of the 10 types, 5 are elementary fractures (top row), and 5 are associated fractures (bottom row). Elementary types involve 1 primary fracture plane. Associated types involve more than 1 fracture plane.
In the system described by Judet and colleagues, 10 patterns of acetabular fracture are defined. The 10 patterns are divided into 5 elementary and 5 associated patterns (see Image 6). Elementary patterns include fractures with a single fracture orientation, whereas associated patterns usually involve combinations of the elementary fractures. Elementary patterns include anterior wall, posterior wall, anterior column, posterior column, and transverse fractures. Associated patterns include both-column fractures, posterior column fractures with posterior wall fractures, transverse fractures with posterior wall fractures, T-shaped fractures, and anterior column fractures with posterior hemitransverse fractures. For simplicity, the 10 patterns can be grouped into 3 categories: wall, column, and transverse fractures. Some fractures fit into 2 categories. The following fractures are indicated by pattern type:
- Wall fractures
- Anterior wall
- Posterior wall
- Posterior column with posterior wall (also a column fracture)
- Transverse with posterior wall (also a transverse fracture)
- Column fractures
- Anterior column
- Posterior column
- Both-column
- Posterior column with posterior wall (also a wall fracture)
- Anterior column with posterior hemitransverse (also a transverse fracture)
- Transverse fractures
- Transverse
- T-shaped
- Transverse with posterior wall (also a wall fracture)
- Anterior column with posterior hemitransverse (also a column fracture)
Fracture patterns
Posterior wall acetabular fracture. Anteroposterior radiograph of the pelvis. The posterior wall of the left acetabulum is disrupted (arrow).
Posterior wall acetabular fracture. A left obturator oblique radiograph of the pelvis. The posterior wall fracture (arrow) is better depicted on this view than on the anteroposterior view.
Both-column fractures are the most common acetabular injury. As the name implies, the anterior and posterior columns are involved (see Image 6). On AP radiographs, a disruption of the iliopectineal and ilioischial lines, as well as the obturator ring, may be seen (see Image 24). An iliac wing fracture may be seen on the AP view, but often, it is appreciated only on the iliac oblique radiograph (see Image 25). The pathognomonic spur sign (see Radiograph Findings) is present on the obturator oblique view (see Image 26) and confirmed on a computed tomography (CT) scan (see Images 27-29).
Both-column acetabular fracture. An anteroposterior radiograph of the pelvis shows that the right ilioischial and iliopectineal lines are completely disrupted. A right iliac wing fracture is noted above the level of the acetabulum (arrow). A nondisplaced fracture of the right inferior pubic ramus is subtle.
Both-column acetabular fracture. A right iliac oblique radiograph of the pelvis. The posterior column (arrowhead) and iliac wing disruptions are shown.
Both-column acetabular fracture. A right obturator oblique radiograph of the pelvis best depicts nondisplaced fractures of the obturator ring (arrowheads). The iliopectineal line disruption (short arrow) signifies anterior column involvement. The pathognomonic spur sign (long arrow) of the both-column fracture is best appreciated on this view. The spur represents a strut of bone extending from the sacroiliac joint. The fracture of both columns disconnects this piece of bone from the acetabulum and causes its spurlike appearance.
Isolated anterior and posterior column fractures are uncommon. Anterior column fractures disrupt the iliopectineal line while preserving the ilioischial line. Conversely, posterior column fractures disrupt the ilioischial line but not the iliopectineal line (see Images 18-23). Column fractures divide the acetabulum into front and back halves (see Image 7). The posterior column fracture with a posterior wall fracture has the features of each of its components (see Image 6). The slightly more common anterior column fracture with a posterior hemitransverse fracture is the most complex acetabular fracture to classify.
The combination of column fractures and transverse fractures may be difficult to appreciate radiographically (see Image 30). The iliopectineal and ilioischial lines are broken, and an iliac wing fracture should be evident. Unlike the both-column fracture, which shares these features, the obturator ring is intact and the spur sign is not present. On CT scans, the anterior column and the posterior transverse fracture planes may be appreciated (see Image 31).
Anterior column fracture with a posterior hemitransverse acetabular fracture, as depicted on computed tomography (CT) scans obtained above and at the level of the right acetabulum. Left: The image shows an iliac wing fracture (arrow) that was not appreciated on the anteroposterior radiograph. (The oblique radiographs were not of good quality.) Middle: The image clearly depicts a column-type fracture (arrow) that is oriented horizontally on the CT scans. Right: The image again demonstrates the column fracture (long arrow), but now a transverse (vertically oriented) fracture can be seen posteriorly (short arrow).
Transverse fractures are transverse because of their appearance when the acetabulum is examined from the lateral view (see Image 6). The iliopectineal and ilioischial lines are interrupted, but the obturator ring is spared. On CT scans, the fracture is oriented vertically (front to back).
Transverse fractures divide the acetabulum into top and bottom halves, as seen on the lateral view of the acetabulum (see Image 7). The transverse fracture with a posterior wall fracture is a common fracture that incorporates the features of transverse and posterior wall elementary fractures (see Images 13-15). The T-shaped fracture is a fairly common acetabular injury. This fracture has the characteristics of an elementary transverse fracture with the addition of a medial acetabular wall fracture extending through the obturator ring (see Images 16-17). The anterior column with posterior hemitransverse fracture is discussed earlier.
In a study by Brandser and colleagues, the following 3 most common types of acetabular fracture accounted for roughly two thirds of all fractures: both-column fractures, transverse fractures with posterior wall fractures, and posterior wall fractures.7 This number increased to 90% when the next 2 most common fracture types were considered: T-shaped and transverse fractures. The frequency of the fractures types is as follows:
- Commonly occurring acetabular fractures (90%)
- Both-column
- Transverse with posterior wall
- Posterior wall
- T-shaped
- Transverse
- Uncommonly occurring acetabular fractures (10%)
- Anterior column
- Anterior column with posterior hemitransverse
- Posterior column with posterior wall
- Posterior column
- Anterior wall
Preferred Examination
AP radiography of the pelvis is used in the initial radiographic assessment of patients with major trauma that is suggestive of pelvic and/or acetabular injury (see Images 2-3).17,18 Images are obtained with the patient in the supine position and with the radiographic beam passing in an AP direction. Abnormalities depicted on the AP pelvis radiograph direct the need for the next set of radiographs. Acetabular fractures are imaged by using oblique (ie, Judet) views of the pelvis. Pelvic ring fractures are imaged by using inlet and outlet views of the pelvis (see Pelvic Ring Fractures).
Anteroposterior view of the pelvis. The left femur has been removed for illustration purposes. The iliopectineal, or iliopubic, line is an important landmark for examining the anterior column of the acetabulum. The ilioischial line demarcates the medial border of the posterior column. The posterior wall of the acetabulum is larger and projects more laterally than does the anterior wall.
Anteroposterior (AP) radiograph of the pelvis (compare with Image above). The iliopectineal (or iliopubic) and ilioischial lines serve as landmarks for the anterior and posterior columns, respectively. The larger and more lateral posterior wall is visualized more easily than is the smaller, more medial anterior wall. The acetabular tear figure is a composite shadow of the inferomedial structures that compose the acetabulum. The ilioischial line should pass through the teardrop on a true AP view of the pelvis.
Oblique, or Judet, radiographs of the pelvis are obtained with the patient in the left posterior oblique and right posterior oblique positions (see Images 4-5). The patient should be at a 45º angle relative to the radiographic beam, which remains perpendicular to the cassette. This technique results in 2 orthogonal radiographs of the pelvis. The patient must be moved to the oblique position; the radiographic tube is not moved so as to be at a 45º angle relative to the patient and film cassette. Angling the tube results in unacceptable radiographic distortion. A common mistake in this radiographic technique is the positioning of the patient in an oblique position that is not steep enough, with a resultant angle of less than 45 º. On an oblique view obtained with good positioning, the coccyx should project over the femoral head.
Left obturator oblique view of the pelvis. The left obturator ring is seen en face. The anterior column and posterior wall of the left acetabulum are profiled in this position.
Left iliac oblique view of the pelvis. The left iliac wing is demonstrated en face. The left posterior column and the anterior wall are seen in profile.
Pelvic CT scans may be obtained alone or in combination with abdominal CT scans during the initial trauma evaluation. Axial CT scans may be obtained, but helical CT scanning yields better 2-dimensional and 3-dimensional reformatted images. Pelvic CT scans allow the detection of subtle fractures and displacements that are not appreciated on radiographs.18
Limitations of Techniques
Virtually all acetabular fractures may be correctly classified after careful interpretation of AP and oblique radiographs of the pelvis. Intra-articular fracture fragments may be difficult to recognize on radiographs.
Compared with radiography, pelvic CT scanning allows a more precise determination of the degree of articular involvement, as well as of fragment displacement and orientation. Pelvic CT scanning also permits the identification of intra-articular fracture fragments. In complex acetabular fractures, 3-dimensional reformatted images may help conceptualize the fracture pattern and, thereby, aid in the planning of orthopedic surgery.
Differential Diagnoses
Pelvic Ring Fractures
Pelvis, Insufficiency Fractures
Other Problems to Be Considered
Hip dislocation
Pelvic avulsion fracture
More on Acetabulum, Fractures |
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| Imaging: Acetabulum, Fractures |
| Multimedia: Acetabulum, Fractures |
| References |
| Further Reading |
| Next Page » |
References
Hunter JC, Brandser EA, Tran KA. Pelvic and Acetabular Trauma. Radiol Clin North Am. 1997;35:559-590. [Medline].
Young JW. Pelvic Injuries. Semin Musculoskelet Radiol. 1998;2(1):83-104. [Medline].
Durkee NJ, Jacobson J, Jamadar D, Karunakar MA, Morag Y, Hayes C. Classification of common acetabular fractures: radiographic and CT appearances. AJR Am J Roentgenol. Oct 2006;187(4):915-25. [Medline].
Olson SA. CT-based acetabular fracture classification. AJR Am J Roentgenol. Jul 2005;185(1):277-8; author reply 278-80. [Medline]. [Full Text].
Lovric I, Jovanovic S, Leksan I, et al. Functional status of hip joint after surgical and conservative treatment of acetabular fracture. Coll Antropol. Mar 2007;31(1):285-9. [Medline].
Letournel E. Fractures of the Acetabulum. 2nd ed. New York, NY: Springer-Verlag; 1993.
Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. Nov 1996;78(11):1632-45. [Medline].
Dakin GJ, Eberhardt AW, Alonso JE, et al. Acetabular fracture patterns: associations with motor vehicle crash information. J Trauma. Dec 1999;47(6):1063-71. [Medline].
Issack PS, Toro JB, Buly RL, et al. Sciatic nerve release following fracture or reconstructive surgery of the acetabulum. J Bone Joint Surg Am. Jul 2007;89(7):1432-7. [Medline].
[Best Evidence] Karunakar MA, Sen A, Bosse MJ, et al. Indometacin as prophylaxis for heterotopic ossification after the operative treatment of fractures of the acetabulum. J Bone Joint Surg Br. Dec 2006;88(12):1613-7. [Medline].
Harris JH Jr, Lee JS, Coupe KJ, et al. Acetabular fractures revisited: part 1, redefinition of the Letournel anterior column. AJR Am J Roentgenol. Jun 2004;182(6):1363-6. [Medline]. [Full Text].
Judet R, Judet J. [Fractures of the acetabulum]. Acta Orthop Belg. May-Jun 1966;32(3):469-76. [Medline].
Pitt MJ, Ruth JT, Benjamin JB. Trauma to the pelvic ring and acetabulum. Semin Roentgenol. Oct 1992;27(4):299-318. [Medline].
Tile M. Fractures of the Pelvis and Acetabulum. 2nd ed. Baltimore, Md: Williams & Wilkins; 1995.
Tile M. Fractures of the acetabulum. In: Rockwood CA, Green DP, Bucholz RW, et al, eds. Rockwood and Green's Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott-Raven; Lippincott-Raven Pub:1996.
Brandser EA, El-Khoury GY, Marsh JL. Acetabular fractures: a systematic approach to classification. Emerg Radiol. 1995;2:18-28.
Borrelli J Jr, Peelle M, McFarland E, Evanoff B, Ricci WM. Computer-reconstructed radiographs are as good as plain radiographs for assessment of acetabular fractures. Am J Orthop. Sep 2008;37(9):455-9; discussion 460. [Medline].
Citak M, Gardner MJ, Kendoff D, Tarte S, Krettek C, Nolte LP, et al. Virtual 3D planning of acetabular fracture reduction. J Orthop Res. Apr 2008;26(4):547-52. [Medline].
Brandser E, Marsh JL. Acetabular fractures: easier classification with a systematic approach. AJR Am J Roentgenol. Nov 1998;171(5):1217-28. [Medline].
Beaulé PE, Dorey FJ, Matta JM. Letournel classification for acetabular fractures. Assessment of interobserver and intraobserver reliability. J Bone Joint Surg Am. Sep 2003;85-A(9):1704-9. [Medline].
Harris JH Jr, Coupe KJ, Lee JS, Trotscher T. Acetabular fractures revisited: part 2, a new CT-based classification. AJR Am J Roentgenol. Jun 2004;182(6):1367-75. [Medline].
Ohashi K, El-Khoury GY, Abu-Zahra KW, Berbaum KS. Interobserver agreement for Letournel acetabular fracture classification with multidetector CT: are standard Judet radiographs necessary?. Radiology. Nov 2006;241(2):386-91. [Medline].
Potter HG, Montgomery KD, Heise CW, et al. MR imaging of acetabular fractures: value in detecting femoral head injury, intraarticular fragments, and sciatic nerve injury. AJR Am J Roentgenol. Oct 1994;163(4):881-6. [Medline].
Cabarrus MC, Ambekar A, Lu Y, Link TM. MRI and CT of insufficiency fractures of the pelvis and the proximal femur. AJR Am J Roentgenol. Oct 2008;191(4):995-1001. [Medline].
Hong RJ, Hughes TH, Gentili A, Chung CB. Magnetic resonance imaging of the hip. J Magn Reson Imaging. Mar 2008;27(3):435-45. [Medline].
Kwon JW, Huh SJ, Yoon YC, Choi SH, Jung JY, Oh D, et al. Pelvic bone complications after radiation therapy of uterine cervical cancer: evaluation with MRI. AJR Am J Roentgenol. Oct 2008;191(4):987-94. [Medline].
Further Reading
Clinical Guidelines and Trials:
ACR Appropriateness Criteria® developmental dysplasia of the hip. American College of Radiology - Medical Specialty Society. 1999 (revised 2005). 8 pages. NGC:004788
ACR Appropriateness Criteria® imaging after total hip arthroplasty (THA). American College of Radiology - Medical Specialty Society. 1998 (revised 2005). 8 pages. NGC:004649
Periacetabular Osteotomy.A Prospective Study With Reference to Cartilage, Migration and Bone Density
Role of Vacuum Assisted Closure (VAC) Device in Postoperative Management of Pelvic and Acetabular Fractures
Unipolar or Bipolar Hemiarthroplasty in the Treatment of Displaced Femoral Neck Fractures. A Randomized Trial of RSA Measurements of Acetabular Wear
Acetabular Fractures of Both Columns
A Clinical Investigation of the C2a-Taper™ Acetabular System
Clinical Study Evaluating an Acetabular Cup System After Total Hip Replacement
Safety and Effectiveness Study of the Reflection Ceramic Acetabular System
The Influence of "Operating Table Position Simulating Radiographs" on Acetabular Cup Angle During Primary Total Hip Replacement
Evaluation of Acetabular Perfusion After Ganz Osteotomy by Positron Emission Tomography
Keywords
acetabulum fracture, acetabulum trauma, acetabular trauma, femur trauma, femoral trauma
