Our surgeons lead a regional service for pelvic reconstructive surgery; a key part of the pelvis is the base of the hip joint or socket (acetabulum). A broken hip socket (acetabular fracture) can be a very challenging injury to manage. These injuries can occur in conjunction with a broken pelvic ring (high energy injury) or in isolation (usually a fall onto the side, e.g. falling off a bicycle at speed). The ball part of the hip acts as a hammer and smashes through the hip socket, breaking the bone.
Patients will be unable to walk following the injury and are in severe pain. Untreated, a large proportion of these injuries may not heal, or rapidly develop to an arthritis joint. We perform detailed scans of all these types of injury (X-rays and CT scans) and if the hip joint has retained its shape and structure then we treat the patient with crutches and protected weight bearing for 6 weeks. Around 65% of patients undergo surgery for this type of fracture, and the aim of surgery is to restore the shape and structure of the hip socket. These can be very demanding and difficult procedures.
Rehabilitation is very important in achieving an optimal result, physiotherapy is essential to regain muscle function. In the early phase, hydrotherapy is very effective.
Patients who sustain acetabular fractures and undergo surgery are very prone to developing a clot (Deep Vein Thrombosis). We give anticoagulants for 6 weeks following surgery to minimise this risk. The other main risk long-term is the development of osteoarthritis of the hip. We monitor all patients with these injuries annually and a proportion of them will eventually undergo hip replacement surgery if their symptoms become severe.