[Acetabular fractures and sacroiliac dislocations].
Involvement of the sacro-iliac joint is frequently associated with acetabular fractures. It was noted on 23 occasions in fractures of both columns of the acetabulum. Tomodensitometry is a key examination which shows lesions which could be missed on standard X-Rays. Dislocations of the sacro-iliac joint diminished the possibility of exact reduction. In 23 cases, only three sacro-iliac lesions were anatomically reduced and 13 hips were well centered. The results obtained after surgical treatment were better than after conservative treatment. This explained the finding that 10 hips developed arthrosis in 14 patients treated conservatively and only 3 in 9 treated surgically. The sacro-iliac involvement was either an anterior opening of the joint leading to an antero-posterior excentration of the hip, or an inferior opening leading to a lateral shift of the iliac bone and a vertical orientation of the acetabulum. In several cases, both types of displacement were present. The diagnosis of the sacro-iliac joint lesion is helped by tomodensitometry though it can also be made by good antero-posterior pelvic radiographs. Conservative treatment using traction was unable to reduce the sacro-iliac lesion, and in some cases it increased the displacement of the iliac bone. Treatment should be by reduction, either using external fixators or by internal fixation.
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed
Fractures du cotyle et disjonctions sacro-iliaques.