Download Fractures of the Acetabulum by Emile Letournel, Robert Judet, Reginald A. Elson PDF

By Emile Letournel, Robert Judet, Reginald A. Elson

On the request of our publishers, I accredited the duty of getting ready this moment variation. I felt this used to be beneficial for a number of purposes: new imaging applied sciences reminiscent of CT scanning and three-D reconstructions at the moment are used frequently, the in­ dications for utilizing more desirable methods are clearer, and reconstructions are facilitated by way of new inner fixation units. mainly, i assumed it was once time to record the long term result of the 940 acetabular fractures, 90070 of which have been taken care of surgically - a different sequence. regardless of the adventure bought from the 3 earlier studies of circumstances (1966, 1971, and 1978), I didn't foresee the quantity of time this revision would want. actually, it took greater than three years to stick with up the bigger variety of circumstances, and 159 sufferers (out of 800, i. e. 22. 7%) weren't incorporated as they'd moved in view that their final evaluate and easily couldn't be positioned. At a time while it truly is in style to judge the price of health and wellbeing care, it's unusual to work out how public directors, so partial to comparing the speedy expense of our opera­ tions, don't care in regards to the caliber in their long term effects, which seems to us, even if, to be the easiest foundation for the alternative of the preliminary therapy.

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Extra info for Fractures of the Acetabulum

Sample text

Ium . The cavity created by the fracture as seen from the outer aspect can vary in size and position. The detached fragment may be in one piece (six cases), in two or more pieces (six cases), or include marginal impaction (three cases). 2 Radiology Oistinct differences are seen in comparison with the previous typical posterior wall fracture . (a) Antero-posterior view. ine and the anterior border of the acetabulum are intact (Fig. 31 A). It is the roof of the acetabulum which is seen to be involved, but the detached fragment appears as before like a cap over the femoral head.

28A-C. Posterior wall fraeture with marginal impaction. A Antcro-posterior view. a diagram. B iliae-oblique view. C obturator-oblique vicw Detached fragment . i i. \ I . { \ A B a / i \ i ,- f \ \ i j i / C Fig. 29. Scheme of postcrosuperior fracture 40 Posterior Wall Fractures Fig. 30. Postero-superior fracture with marginal impaction. The roof has been almost totally detached in several fragments. i \ ',. I" , - . 1 Morphology The detached fragment comprises the posterosuperior sector of the acetabulum (Fig.

The location of this line on the dried specimen is seen to coincide alm ost exactly with the outline of the segment of bone producing the image of the inner limit of the iliac wing. Note that the outer limit of the iliac wing, as seen on this view, is produced by the pillar supporting the gluteus medius tuberc1e of the crest (Fig. 18 b, C 1) and lies much more anteriorly. In summary, the shadow of section of the iliac wing is marked by three principallines. These are: (a) the extern al limit which corresponds to the anterior pillar of bone supporting the iliac crest; (b) the internallimit wh ich appears to be a prolongation of the pelvic brim and corresponds to the most concave part of the iliac fossa; and (c) an intermediate line with respect to the external and internal limits, tangential to them or cutting them, and which represents the most concave part of the projection considered here of the gluteal surface.

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