Fractures of the acetabulum: from yesterday to tomorrow

Abstract

Purpose: The aim of this article is to present history, state of the art, and future trends in the treatment of acetabular fractures.

Methods: Review of recent and historical literature.

Results: Acetabular fractures are difficult to treat. The first descriptions of this injury already appeared in ancient Greek history, but intensive development started in the second half of the twentieth century after Judet and Letournel's seminal work. Their classification is still the gold standard today. It is actually a pre-operative planning system and is used to determine the most appropriate surgical approach. The therapy of choice for dislocated fractures is open reduction and internal fixation. Recent modern techniques based on high-tech computerized planning systems and 3D printing have been successfully integrated into orthopaedic trauma practice.

Conclusion: There is no ideal surgical approach for acetabulum fracture treatment, so new approaches have been developed in recent decades. The best outcome series have shown good or excellent results, between 70 and 80%.

Keywords: Acetabulum; Approaches; Fracture; History; Planning.

Fig. 1

Process of 3D planning: a comminuted anterior column fracture of the acetabulum in a 65-year-old male, b fracture segmentation using pre-operative planning software, c a reduced size 3D-printed model enables visual and tactile understanding, d virtual reduction and individual designed shape of the plate, e, f individual designed 3D-printed plastic plates according to virtually reduced fracture serves as a template to contour reconstruction plates, g result 3 years after open reduction and internal fixation (the Pararectus surgical approach was used)