PMC3528042_01
A left hip anteroposterior x-ray in a 75-year-old female
patient with groin pain. No acetabular abnormalities visible. Lateral
migration of the hip screw nails.
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F1
There were no signs of acetabular fracture on this AP projection (Fig. 1).
X-ray of the same patient two months later. The medially-migrated
femoral head, with an acetabular transverse fracture, is
evident.
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F2
X-ray of the same patient at one year follow-up. Cemented
hip replacement with proximal acetabular cup migration.
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F3
A cemented total hip replacement was performed, with no osteosynthesis or bone graft of the acetabular fracture (Fig. 3); bone and soft tissue samples obtained intraopera-tively were negative for bacteriological cultures.
Five year follow-up.
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F4
Six year follow-up X-rays showed proximal migration and medialization of the acetabular component (Figs. 4, 5).
Six year follow-up.
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F5
Six year follow-up X-rays showed proximal migration and medialization of the acetabular component (Figs. 4, 5).
PMC3528042_02
Anteroposterior pelvis x-ray of an 80-year-old female
patient. Normal osteosynthesis of a left perthrocanteric fracture at
2-year follow-up with a screw-nail device can be seen.
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F6
No abnormalities were seen in the AP pelvis X-ray (Fig. 6). Careful examination of the initial X-rays revealed that the ilio-ischial line was interrupted at the greater sciatic notch (Fig. 6).
Anteroposterior pelvis X-ray of the same patient, one
month later. A left acetabular transverse fracture is evident, with
mild medial displacement of the femoral head.
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F7
At the one-month evaluation she still had groin and thigh pain, and a left transverse acetabular fracture with mild medial protrusion of the femoral head was observed radiologically (Fig. 7 - arrow-).
Anteroposterior pelvis X-ray two months later. Fracture
consolidation.
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F8
A subsequent x-ray, 2 months later, showed that the fracture had probably healed (Fig. 8).
PMC3528042_03
No fracture was found, although thickening of both
iliopubic rami and ischia could be seen, resembling the prior stage
of a stress fracture.
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F9
Thickening of both iliopubic rami and ischia was found, as a previous stage of a stress fracture (Fig. 9).
Anteroposterior x-ray of an 83-year-old patient with groin
pain. Non-union of the right anterior acetabular column and
ischium can be seen. An apparently healed fracture in the left
anterior acetabular column is also visible.
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F10
As the pain increased during the following weeks, another X-ray was taken two months later (Fig. 10).
Anteroposterior x-ray of the same patient at one year
follow-up. Non-union is not resolved.
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F11
Home bed rest without traction for two weeks followed by walking with weight bearing was prescribed, and during follow-up a non-union of the fractures became evident (Fig. 11).