Fractures in adolescents

A 13-year-old girl fell while skiing and was taken to a local hospital. Radiographs were obtained and revealed a right-sided Anterior Column with Posterior Hemi Transverse acetabular fracture.

She was placed in skeletal traction and transferred to us for definitive management of her acetabular fracture. Open reduction and internal fixation was performed with placement of contoured plates and screws.

She returned for regular follow-up visits and healed uneventfully and at her most recent follow-up visit at 8.5 years following surgery she has excellent clinical and radiographic results and reported complete resolution of pain with full range of motion in the hip joint.

  • Figure A, B

    Figure A, B

    (A) Anteroposterior (AP) and (B) iliac oblique x-ray views reveal a right-sided Anterior Column with Posterior Hemi Transverse acetabular fracture.

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  • Figure C, D

    Figure C, D

    (C) CT scans and (D) 3 dimensional CT reconstruction images further delineate the fracture pattern.

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  • Figure E, F

    Figure E, F

    ORIF was performed using an ilioingunal approach. (E) The fracture was reduced and stabilized using a contoured 10-hole pelvic reconstruction plate and screws and placement of a spring plate along the anterior wall fracture. Post-operative CT scan images (F) illustrate an adequate reduction.

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  • Figure G, H, I

    Figure G, H, I

    The patient returned at 8.5 years following ORIF and (G) AP, (H) obturator oblique, and (I) iliac oblique radiographs demonstrate a healed acetabular fracture and maintenance of joint space. She had fully returned to a normal activities and reported no pain.

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David L. Helfet, MD

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New York Fracture Care

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