Acetabular fractures are serious orthopedic injuries that occur when the femoral head is driven through the acetabulum, sometimes resulting in hip dislocation. They require rapid treatment and often surgery due to difficult access and proximity to blood vessels and nerves. Patients typically experience intense pain, swelling, deformity, and limited range of motion. While traction and immobilization are initial treatments, most patients need open reduction and internal fixation surgery to precisely realign the bones and prevent long-term issues. Major post-operative concerns include blood clots, infections, and avascular necrosis of the femoral head. Extensive physical therapy focuses on range of motion, strength, and mobility exercises to aid recovery.

1. Acetabular Fractures
By: Mallory Roelke
Ashley Van Genderen
Lisa Vander Plaats

2. Overview
• Acetabulum fractures are one of the most
serious injuries treated by orthopedic
surgeons
• Requires rapid and precise treatment and
sometimes surgical procedures
• All ages are vulnerable

3. Causes
• Result of a motor vehicle accident
• Bad fall
• Osteoporosis in elderly patients

4. pathophysiology
• The femoral head is driven through the acetabulum
due to traumatic injury and the femoral head ends
up outside the acetabulum which is also known as a
hip dislocation which most patients will have along
with a fracture
• More difficult to treat do to the fact the access to the
bone is more difficult to get at
and the proximity to the major
blood vessels and nerves that
innervate the lower extremities
• Fracture of the cup where the
femoral head sits in pelvis

5. Signs and Symtoms
• Intense pain in injured area
• Swelling
• Obvious deformity
• Difficulty with ROM
• Inflammation signs
• Contusions
• Leg length discrepancies

6. Facts
• Almost all patients always experience serious
injury to surrounding soft tissue and
neurovascular structures
• There is usually significant bleeding and risk of
nerve damage

7. Treatment
• Most patients will require and
open reduction with internal
fixation.
• Surgeon realigns the bone
precisely as possible to prevent
post op issues
• Usually not treated until 5-10 days
following injury due to the patient
experiencing significant bleeding
they wait for the patients own
clotting mechanisms take effect
• During this time may be in
traction to prevent additional
injury

8. Complication Concerns
• DVT or Pulmonary embolisms
• Pneumonia
• Skin problems
• Muscle complications due to inactivity
• Heterotrophic ossification
• Damage to head of femur
• Avascular necrosis of the head of the femur
• Nutritional problems
• Constipation
• Infection at the site of injury

9. Modalities for non-operative care
• Traction
• Early mobilization
• Progressive weight bearing
• Soft tissue massage
• Passive range of motion

10. Therapeutic Exercises
• Aerobic capacity/ endurance conditioning or
reconditioning
– Gait training
– Increase workload overtime
– Walking and wheelchair propulsion programs

11. Therapeutic Exercises
• Balance, coordination and agility training
– Neuromuscular education or reeducation
– Perceptual training
– Posture awareness training
• Body mechanics and postural stabilization
– Body mechanics training
– Posture awareness and control training
– Postural stabilization activities

12. Therapeutic Exercises
• Flexibility exercises
– Muscle lengthening
– Range of Motion
– Stretching
• Gait and locomotion training
– Developmental activities training
– Gait training
– Implement and device training

13. Therapeutic Exercises
• Relaxation
– Breathing strategies
– Movement strategies
– Relaxation techniques
• Strength, power, and endurance exercises
– Active assistive, active, and resistive exercises
(including concentric, dynamic/isotonic, eccentric,
isokinetic, isometric, and plyometric)
– Task specific performance training

14. ADL Training
• Bathing
• Bed mobility and transfer training
• Developmental activities
• Dressing
• Eating
• Grooming
• Toileting

15. Bibliography
• American Physical Therapy Association, First. Guide to Physical
Therapist Practice. Second Edition. Alexandria, Virginia: American
Physical Therapy Association, 2001. 4-H. Print.
• Fracture, Pelvic: eMedicine Emergency Medicine. N.p., 2010. Web. 19 Nov
2010. http://www.emedicine.medscape.com/article/825869-overview .
• Novick, Nancy. "Hospital for Special Surgery." Pelvic Fractures/Fractures of
the Acetabulum. N.p., 09/16/2009. Web. 22 Nov 2010.
http://www.hss.edu/conditions_pelvic-acetabulum-fractures.asp .
• Thacker Mihir M. "eMedicine." Acetabulum Fractures. N.p., 08/07/2009.
Web. 20 Nov 2010. http://emedicine.medscape.com/article/1246057-
overview .
• All pictures retrieved from www.google.com