27228 Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, wit

Name of the Procedure:

Open Treatment of Acetabular Fracture(s) Involving Anterior and Posterior Columns (including T-fracture and Both Column Fracture with Complete Articular Detachment, or Single Column or Transverse Fracture with Associated Acetabular Wall Fracture).

Summary

This surgical procedure involves the open repair of complex fractures of the acetabulum, the socket of the hip bone. It addresses fractures affecting both the anterior and posterior columns of the acetabulum, including T-fractures and both column fractures with complete articular detachment, or single column or transverse fractures with associated acetabular wall fractures.

Purpose

This procedure is performed to:

• Correct severe fractures of the acetabulum.
• Restore the normal anatomy and function of the hip joint.
• Prevent long-term complications such as hip dislocation, arthritis, or mobility issues.

Indications

The procedure is indicated for patients with:

• Severe acetabular fractures involving both anterior and posterior columns.
• T-fractures and both column fractures with complete articular detachment.
• Single column or transverse fractures with associated acetabular wall fractures.
• Inability to achieve satisfactory fracture alignment and stabilization through non-surgical methods.

Preparation

• Patients may need to fast for a specific period before surgery.
• Blood tests, imaging studies (e.g., X-rays, CT scans), and preoperative assessments are conducted.
• Medications may need to be adjusted, with particular attention to blood thinners.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: An appropriate incision is made to access the acetabulum.
3. Fracture Exposure: Soft tissues and muscles are carefully moved aside to expose the fractured bone.
4. Fracture Reduction: The fractured bone fragments are realigned and fixed using plates and screws.
5. Stabilization: The bone is secured to ensure proper healing and function of the hip joint.
6. Closure: The incision is closed layer-by-layer, and a sterile dressing is applied.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the fracture.

Setting

This surgery is performed in a hospital operating room under sterile conditions.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technologists

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve damage
• Nonunion or malunion of the fracture
• Hip dislocation
• Arthritis development
• Need for further surgery

Benefits

• Restored anatomy and function of the hip joint.
• Reduced risk of long-term complications.
• Improved mobility and pain relief.
• Better quality of life post-recovery.

Recovery

• Pain management with medications and possible use of a nerve block.
• Physical therapy to regain strength and mobility.
• Limited weight-bearing on the affected leg for several weeks.
• Follow-up appointments to monitor healing.
• Full recovery may take several months.

Alternatives

• Non-surgical management with traction or casting (less effective for severe fractures).
• Percutaneous fixation (minimally invasive but not suitable for all fracture types).
• Hemiarthroplasty or total hip arthroplasty (hip replacement, used if joint damage is severe).

Patient Experience

• During the procedure: The patient will be under general anesthesia and will not feel anything.
• After the procedure: Pain and discomfort are expected, manageable with medication. Physical therapy is crucial for recovery. Some patients may need assistance with daily activities initially.