CENTRAL FRACTURE OF THE ACETABULUM

With a Report of a Case

¹ Assistant Surgeon to the Hospital for Ruptured and Crippled

The principal points to be emphasized are as follows:

1. The importance of an early diagnosis, in making which, one should be guided by the history of a blow over the great trochanter, tenderness and disability of the hip-joint, and, most important of all, an early roentgenogram which will render the diagnosis certain.

2. The value of the Whitman abduction method of treatment of these fractures, by means of which the central luxation of the head of the femur is reduced, owing to the strong leverage which can be applied to the femur in such a manner as to cause the head to be withdrawn from the [See Fig in Source Pdf.] pelvis, the impingement of the great trochanter on the superior rim of the acetabulum acting as a fulcrum.

3. Early mobilization of the ankle and knee joint, together with [See Fig. 5, 6, in PDF Source.] massage, followed by gentle passive motion of the hip, and later active motion and weight-bearing, which may be allowed at three months. The use of the walking machine is helpful in the early stages of weight-bearing, and crutches for several weeks thereafter. Restoration of the continuity of the acetabulum, as in the case here reported, may be remarkably complete.

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