Presentation
Fall. Unable to weight bear. Pelvic pain.
Patient Data
Displaced and comminuted fracture of the left acetabulum extending to the left superior pubic rami. No dislocation but the femoral head is displaced medially and superiorly. Old right pubic rami fractures are noted.
Comminuted left acetabular fracture with medial and superior displacement of the femoral head. Fractures extends to both the ilium and superior pubic ramus. Left inferior pubic rami fracture. Small volume of associated extraperitoneal hematoma. Sacro-iliac joints and pubic symphysis are congruent. No sacral fracture.
Old non-united right inferior pubic ramus fracture. Old superior pubic ramus / pubic body fracture.
Case Discussion
This fracture is a "both-column" injury - where the anterior and posterior columns are disrupted with extension to the obturator ring and iliac wing. This is the most common acetabular fracture pattern.
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