05/09/2021
POSTERIOR WALL ACETABULAR FRACTURES: WHEN TO FIX VS FIX & REPLACE
This is a 72 year old woman that was in a car crash and sustained a posterior wall (hip socket) fracture dislocation.
Due to her age, impaction, multifragmentary fracture, femoral head dent and associated dislocation we went with combined fixation and hip replacement.
She was walking right after surgery and is doing well 2+ years postop.
The decision to fix alone vs. fix with replacement is often challenging. However, the decision to recommend replacement was fairly straightforward for her as she is a high-functioning individual with many strong risk factors for failure.
I have no regrets about the decision to recommend replacement and I’m happy with her outcome. Two critiques for this case are 1) the cup position is too vertical, 2) one of the screws is too long.