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Fracture Care Program

Hip Fractures

Acetabular or hip fractures occur in the area where the pelvis meets the head of the femur, known as the “hip socket.” The acetabulum is actually the “socket” in the “ball-and-socket” hip joint.

Although somewhat uncommon, these complex fractures are usually caused by direct trauma (e.g., high falls, auto accidents) to the pelvis and/or thighbone. Elderly patients often suffer these fractures due to their weakened bones. Patients often find it difficult or impossible to walk on the damaged limb(s), with any hip movements leading to pain and muscle spasms.

At Florida Hospital Orlando, we can successfully treat acetabular fractures with surgery. Today, the orthopedic surgeons at the Florida Hospital Orthopaedic Institute Orlando (FHOIO) regularly diagnose and treat acetabular fractures or hip fractures using minimally invasive techniques, employing their experience and knowledge to further innovations in this area of orthopedics.

Treatments

If our experts suspect an acetabular fracture, or any type of hip fracture, the FHOIO staff will first perform diagnostic exams—specifically, pelvic X-rays and CAT scans. Once the fracture is confirmed, the surgical team will determine the best course of treatment. This may depend on factors such as hip stability and the level of cartilage displacement.

Non-surgical treatment options may be provided for those without displaced/dislocated fractures, or those unable to undergo surgery (in many cases, the elderly). Typically, realignments are performed through manipulation. However, if surgery is necessary, our goals are to realign and stabilize the patient’s displaced joint surfaces. Besides allowing patients to avoid extended bed rest and traction, these procedures offer three benefits:  

  • The area’s cartilage surface is properly aligned
  • Bone and other debris are removed from the hip joint
  • The hip’s stability is restored

At the Florida Hospital Orthopaedic Institute Orlando, surgeons may perform a procedure called an “open reduction,” in which an incision is made to directly manipulate the bone. Alternately, they may perform a “closed reduction,” which doesn’t require incisions. Both require fixations once the realignment is achieved; the fixation may use wires, pins, screws and plates to properly secure the bones while they heal. Depending on the severity of the fracture, multiple procedures may be required.

For an acetabular fracture, especially those with displaced joints, a procedure called an open reduction with internal fixation (ORIF) may be used. This involves the precise realignment or reductions of damaged bones, which are then strongly secured. Consequently, future displacement is avoided and healing begins quickly.

These procedures are very successful, with research suggesting that 80–85 percent of patients should expect “good” to “excellent” post-surgical recoveries. We encourage you to make an appointment today.

Patient stories

John, an active tri-athlete, became distracted while cycling one day and drove his bike off the road. He landed directly on his hip, sustaining a serious acetabular fracture. Physicians initially told John that he would have trouble walking, and his days as a tri-athlete were over.

John was referred to Dr. J. Dean Cole by surgeons who were familiar with J. Dean Cole, MD’s reputation as one of the first surgeons to develop a minimally invasive approach to treating acetabular fractures. J. Dean Cole, MD published a paper on this technique, referred to as the “Stoppa Approach,” in 1994, after his minimally invasive procedure was developed. To John, having a surgeon with extensive experience in the treatment of acetabular fractures meant that he could walk and possibly compete again. Because of John’s complex injury, his surgery involved this minimally invasive anterior approach as well as a posterior approach. 

Today, John has fully recovered, and is once again competing in triathlons.