Fractures of the acetabulum are becoming more common due to high-speed vehicles on bad roads. They assume great clinical significance since it involves a major weight-bearing joint in the lower extremity. Anatomical reduction is a prerequisite for good long-term function of the hip joint. This may be obtained either by closed or open methods. But more often than not it requires open reduction and stable internal fixation to facilitate early active or passive motion. There is unanimity of opinion that joint congruity is essential for good long-term function. Hence displaced acetabular fractures merit a stable internal fixation.
There are various factors affecting the outcome:
The degree of initial displacement
The damage to the weight bearing dome of the acetabulum
The degree of hip joint instability
The adequacy of reduction either open or closed
Associated pelvic ring injury
Associated damage to neuro-vascular structures and viscera
The late complications of avascular necrosis of the femoral head, heterotopic ossification, chondrolysis and degenerative arthrosis.
With the advent of CT scan, 3D reconstruction and construction of bone model from the CT scan data, it has become easier to classify these complex injuries and treat them more effectively. The availability of image-guided surgery is further likely to reduce the surgical morbidity and improve the results of surgery and is likely to reduce the slope of the otherwise steep learning curve.
In this symposium, we have covered various aspects of this complex topic. I am sure it will arouse interest in the post graduates, will help the occasional acetabulum surgeon to understand it even better and will widen the horizons for the experienced.
I would like to express my gratitude to the contributors for doing an excellent job in compiling the information contained in this symposium.