An acetabular fracture is a break in your acetabulum. Your acetabulum is the socket part of the hip joint. Acetabular fracture types are classified by pattern and severity. Acetabular fractures are painful injuries that usually require surgery. Complications such as hip arthritis can arise due to the cartilage that surrounds your hip socket.
An acetabular fracture is a break in your hip socket. Your hip is a “ball-and-socket” joint. Your acetabulum, which is part of your pelvis, forms the socket. Your femoral head, which is the upper end of your femur (thigh bone), forms the ball. The ball-and-socket joint allows movement between your thigh bone and your pelvis. This joint is what lets you walk.
An acetabular fracture can cause a significant loss of motion and function. Acetabular fractures are much less common than most hip fractures. Most hip fractures are in the upper femur or femoral head.
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Acetabular fractures can occur on your left or right. Your acetabulum can break in different places and in different ways called patterns. These patterns are based on location, orientation or in a combination. Acetabular fractures include:
Sometimes an acetabulum breaks straight across and other times it shatters into pieces. The severity of your fracture depends on the following factors:
Open or compound fractures (when bone fragments stick out of the skin) are particularly severe because infection can occur in both the bone and the wound.
Knowing the pattern and severity of your fracture can help your healthcare provider determine the correct treatment for you.
The bones of your pelvis, including your acetabulum, are very strong. It would take a strong force to break them. Acetabular fractures most commonly occur due to high-energy injuries. These injuries include car and motorcycle accidents and falls from significant heights. Acetabular fractures occur due to weakened bones, too. Some older people with osteoporosis get acetabular fractures after simple falls.
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An acetabulum fracture causes severe hip pain. The pain is sometimes worsened with movement. If you’ve damaged any nerves, you may feel numbness or a tingling sensation down your leg. You may also feel weakness in your leg.
Your healthcare provider will examine your pelvis, hips and legs. They may:
Your healthcare provider may also request the following imaging tests:
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Treatment for an acetabular fracture depends on the pattern of fracture and severity of your injury. If your fracture is stable and the bones are in place, surgery may not be necessary. Your healthcare provider may recommend:
An acetabular fracture can cause difficult complications. These include:
After surgery, you’ll experience pain. Your healthcare provider can prescribe a medication to help with the pain. These medications may include non-steroidal anti-inflammatory drugs (NSAIDs) or local anesthetics.
When you start walking again, you may have to use crutches or a walker. You may be able to put partial weight on your leg after six to eight weeks. You won’t be able to put full weight on your leg for a few months. You may have to continue using your walking aid.
Your healthcare provider may recommend early physical therapy to begin moving your hip again. Exercise can help build strength and endurance in your hip. Over time, your healthcare provider may allow additional low-impact exercises such as swimming or riding a stationary bike. You won’t be able to engage in more physical activity for six to 12 months.
Your outcome will depend on the pattern and severity of your injury, as well as other factors such as your age and medical history. Long-term complications are a concern after an acetabular fracture. Arthritis in your hip is of particular concern because of the cartilage surrounding your hip socket. While some people return to normal functioning, many people don’t return to the same level of activity they participated in before.
It takes eight to 12 weeks for an acetabular fracture to heal. The outcome varies depending on the severity of the fracture, type of fracture, any other injuries sustained, your age, health history and smoking status. (Smoking can hinder the healing process and also increases your risk for complications.)
If your fracture is stable and the bones are in place, surgery may not be necessary. However, you will still need non-surgical treatment from a healthcare provider. This may include recommendations for walking aids, positioning aids and medications.
Surgical time varies by the severity of the fracture and may range from two to six hours.
A note from Cleveland Clinic
An acetabular fracture is a painful injury usually caused by a high-impact accident, but it sometimes occurs due to weakened bones caused by osteoporosis. If you have an acetabular fracture, you should see your healthcare provider right away. Acetabular fractures usually require surgery to repair. Acetabular fractures are severe injuries, and they also come with a likelihood of complications. Talk to your healthcare provider about the best treatment and recovery plan for you. In time, you may be able to get back to the activities you enjoyed before your injury.
Last reviewed on 10/08/2021.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy