Posterior Acetabular Rim Fractures

Abstract

Unlike other fracture regions, arthroscopic management of the hip joint is reasonable in terms of minimal invasiveness. However, only a limited number of patients with hip trauma are treated using hip arthroscopy due to limited indications and safe positioning for trauma patients. In this paper, arthroscopic treatment of a patient with posterior acetabular rim fracture and intra-articular loose bodies after posterior dislocation of the hip is presented and arthroscopic management of posterior acetabulum fractures in trauma patients are reviewed.

In this case, the treatment was arthroscopic fixation of the rim fracture and labrum repair with a knotless anchor and debridement of intra-articular loose bodies. In contrast to previous reports, fixation was made with an anchor because the fractured rim was relatively small. Bioabsorbable internal fixation screws, absorbable or radiolucent anchors, and sutures are other possible fixation alternatives that can be used in arthroscopic-assisted fracture fixation. This opportunity also allowed for evaluation of other intra-articular structures such as the ligamentum teres, femoral head and acetabular chondral surface, and anterior labrum in addition to the posterior labrum and posterior acetabular rim.

Hip arthroscopy in trauma patients can be used to repair acetabular fractures, however, with limited indications, such as Thompson-Epstein types 1 and 2, with the advantage of minimal invasiveness in contrast to open arthrotomy and direct visualization and reduced exposure to radiation in contrast to percutaneous acetabular fracture fixation under fluoroscopic guidance. Moreover, there is a good opportunity to remove loose bodies, which have not been diagnosed preoperatively, and to diagnose and treat other intra-articular pathologies that may cause residual hip pain and possibly lead to early osteoarthritis.