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[Strategy of prevention and management of intraoperative fractures of acetabulum during primary total hip arthroplasty].

OBJECTIVE
To analyse the causes and resultes of intraoperative occurrence of an acetabular fracture in primary total hip arthroplasty and discuss propriate prevention and treatment of this problem.


METHODS
Between July 2004 and December 2006, 326 primary total hip arthroplasties were retrospectively reviewed and found that eleven patients (eleven hips) had sustained an intraoperative acetabular fracture involving 7 male and 4 female,aged from 37 to 71 years (mean 54 years). Analyzed the causes of fractures, the anatomic location, treatment and outcome of the fractures. Acetabular component designs were categorized and each design was analyzed for fracture risk.


RESULTS
Among 11 cases, the fractures occurrenced as setting the prosthesis in 6 cases, grinding and drilling in 3 cases, drawning hook in 2 cases. There were 5 cases of central type fracture, 3 of posterior-wall, 2 of anterior, 1 of posterior-upper. Nine of these patients (nine hips) had been followed-up for 12 to 29 months(mean 18 months). There were no heterotopic ossification, no dislocation, no deep venous embolism. All fractures were healing.


CONCLUSION
Acetabular fracture during primary total hip arthroplasty is a complication of acetabular fixation without cement, which should be think highly of. In the present series, retention of a stable cup is associated with uneventful osseous in growth and excellent early-term outcomes.