Osteochondral impaction of the posterior acetabular surface without cortical fracture of any wall or column: an undescribed pattern of acetabular injury

Pascarella, R; Digennaro, Vitantonio; Grandi, G

doi:10.1007/s10195-011-0139-x

Cited by 9 publications

(7 citation statements)

References 10 publications

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“…The technique is useful only when fracture involves the Q surface. Recently, Pascarella et al [40] reported an undescribed pattern of acetabular injury. There was osteochondral impaction of the posterior acetabular surface without cortical fracture of any wall or column.…”

Section: Discussionmentioning

confidence: 99%

The study of broken quadrilateral surface in fractures of the acetabulum

Prasartritha

Chaivanichsiri

2013

International Orthopaedics (SICOT)

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Purpose Three-dimensional computerised tomography (3DCT) can provide comprehensive patho-anatomy of complex bone on a single image. Though important, the key articular quadrilateral [Q] surface has not been a part of the systems developed for classifying acetabulum fractures. The purpose of the study was to simplify the complexity of classification by the direct sign of the broken Q surface which lies opposite the entire floor of the acetabulum. Methods The study reviewed 84 acetabular fractures using 3DCT images of the interior lateral view (IL) taken between June 2002 to December 2009. Fractures were traditionally classified using the anatomical disruption, plane of the fracture line breaking through or not through the bone column described by Judet and Letournel. Results The 3D images clearly show the primary site of impaction acting on the acetabulum and the whole course of fracture. The image could not illustrate disruption of the lips of acetabulum and congruity of hip joints in 20 cases of wall (W) fracture. There were 30 transverse (T) fractures classified when the acetabulum was divided horizontally from front to back into upper and lower parts and 34 cases of column (C) fracture when the main vertical lines run and collide along the anterior and posterior column. Conclusions This study showed that the well-known complex fractures can be satisfactorily classified with the broad flat inner plane of the Q surface.

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Section: Discussionmentioning

confidence: 99%

The study of broken quadrilateral surface in fractures of the acetabulum

Prasartritha

Chaivanichsiri

2013

International Orthopaedics (SICOT)

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“…In another case reported by Pascarella et al an impacted fracture of the posteroinferior articular surface of the acetabulum with comminution of the quadrilateral lamina and fracture of the ischial bone has been discussed. In their case anterior and posterior columns were intact (12). This case also cannot be classified using the commonly used classification systems.…”

Section: Discussionmentioning

confidence: 99%

“…have reported an isolated quadrilateral plate fracture of the pelvis with no involvement of either column but with an impaction fracture of the femoral head, which also cannot be classified according to the commonly used classification systems ( 11 ).In another case reported by Pascarella et al an impacted fracture of the posteroinferior articular surface of the acetabulum with comminution of the quadrilateral lamina and fracture of the ischial bone has been discussed. In their case anterior and posterior columns were intact ( 12 ). This case also cannot be classified using the commonly used classification systems.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

et al. 2013

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IntroductionAcetabular fractures are a common problem among young males. An acetabular fracture with disruption of the joint surface, if untreated, will rapidly lead to post-traumatic osteoarthritis. Proper reduction and internal fixation depend on accurate classification and the quality of imaging.Case PresentationWe present an unusual form of acetabular fracture, which is not included in the conventional classification (Judet and Letournel) ; this occurred in a middle-aged male who was operatively treated without any complications. In this case due to posterior extension of the fracture into the SI joint and concomitant anterior column fracture in the area above the acetabular dome, no portion of the acetabular anterior surface remained connected to the innominate bone.ConclusionsWe recognized this type of fracture and treated it similarly to both column fractures. We recommend that the classification of acetabular fractures be modified to include this type of fracture.

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“…Once the decision to operate has been made, the operative technique, open or laparoscopic surgery, must be decided. The laparoscopy is most often recommended during the first two trimesters, as alternative diagnoses can be evaluated in case of normal appendix [ 9 - 14 ]. During the third trimester, guidelines are less clear.…”

Section: Introductionmentioning

confidence: 99%

“…During the third trimester, guidelines are less clear. Many speak for the open approach, especially after the 26 th -28 th week of amenorrhea, but an increasing number of publications now report series of successful laparoscopic appendectomies during the third trimester [ 7 , 9 , 10 , 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

et al. 2011

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The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this «near miss» complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea). In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed.

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Osteochondral impaction of the posterior acetabular surface without cortical fracture of any wall or column: an undescribed pattern of acetabular injury

Cited by 9 publications

References 10 publications

The study of broken quadrilateral surface in fractures of the acetabulum

The study of broken quadrilateral surface in fractures of the acetabulum

An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

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