Atypical anterior wall fracture of the acetabulum: case series of anterior acetabular rim fracture without involvement of the pelvic brim.
OBJECTIVE
The purpose of this study was to describe a form of anterior wall acetabular fracture, which has been inadequately defined in the literature.


METHODS
Retrospective analysis of consecutive patients.


METHODS
Level 1 trauma center.


METHODS
A retrospective analysis of consecutive acetabulum patients treated by a single surgeon between 1999 and 2005 identified 6 patients with a form of anterior wall fracture without involvement of the pelvic brim. All fractures were treated operatively.


METHODS
Open reduction and internal fixation through an anterior surgical approach.


METHODS
Final radiographic appearance and modified Merle d'Aubigne score.


RESULTS
All 6 cases demonstrated characteristics of an atypical fracture of the anterior wall, involving the anterior rim of the acetabulum similar in nature to those described for the posterior wall, rather than the standard anterior wall fracture type described by Letournel. Of the 6 cases that were identified, 5 had follow-up 1 year or greater with a mean modified Merle d'Aubigne Score of 17 (range: 17-18).


CONCLUSIONS
A form of anterior wall acetabular fracture exists, which involves the anterior acetabular rim without involvement of the pelvic brim. It can occur in young patients with high-energy mechanisms of injury, as well as in the elderly with low-energy trauma. With appropriate surgical management, using a modified Smith-Peterson approach, good to excellent clinical outcomes should be expected.
Lenarz
Christopher J
CJ
Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, Missouri 63110-8850, USA.
Moed
Berton R
BR
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome