All about pelvic and acetabular fracture surgery

Written by: Mr Andrew Gray
Edited by: Karolyn Judge

Pelvic and acetabular fractures pose unique challenges that require specialised care. Leading orthopaedic surgeon Mr Andrew Gray aims to provide clear and informative answers to some common questions that can be asked after this serious injury that often requires surgery.

Surgeons undertaking a pelvic and acetabular fracture surgery

What are pelvic and acetabular fractures?

Pelvic fractures involve a break in the bones of the pelvis, which can be caused by various traumatic events such as motor vehicle accidents or falls. These fractures can vary in severity, from stable fractures that may not require surgery to more complex and unstable fractures.


Acetabular fractures, on the other hand, specifically involve the hip socket (acetabulum). This type of fracture often occurs in conjunction with pelvic fractures or as a result of high-energy impacts. There is also a group of elderly and frail patients that can sustain an acetabular fracture after a fall from a standing height. Acetabular fractures can severely affect hip joint stability and function.



What causes pelvic and acetabular fractures?

Pelvic and acetabular fractures are typically caused by significant trauma, such as:

  • Motor vehicle accidents
  • Falling from heights
  • Athletic injuries
  • Industrial accidents
  • High-energy impacts
  • Understanding the cause of your fracture is essential for the orthopaedic surgeon to determine the most appropriate treatment approach.



How are pelvic and acetabular fractures diagnosed?

Diagnosing these fractures typically involves a combination of physical examinations, X-rays, CT scans, and sometimes MRI scans. These imaging studies help us evaluate the extent of the fracture and the associated soft tissue damage, enabling us to make informed decisions about treatment.



Do all pelvic and acetabular fractures require surgery?

No, not all pelvic and acetabular fractures necessitate surgery. The treatment approach depends on several factors, including the type, displacement and severity of the fracture, the patient's overall health, and their functional goals.


Stable fractures may be managed conservatively with pain management, rest, and physiotherapy. However, unstable or displaced fractures often require surgical intervention to restore stability and ensure proper healing.



What surgical options are available?

Orthopaedic surgeons employ various surgical techniques to manage pelvic and acetabular fractures. Some common surgical procedures include:

Open Reduction and Internal Fixation (ORIF)

This procedure involves surgically realigning the fractured bones and using screws, plates, or other devices to stabilise the fracture. This is complex surgery performed in a specialist centre.


External Fixation

In cases of severe fractures, external fixation devices may be used temporarily to stabilise the pelvis or acetabulum.


Total Hip Replacement (THR)

In cases where the hip joint is severely damaged, a total hip replacement may be recommended to restore joint function.


Minimally Invasive Surgery

Some fractures can be treated using minimally invasive techniques, which result in smaller incisions and potentially faster recovery times.


What is the recovery process like?

Recovery from pelvic and acetabular fractures can be lengthy and often involves a combination of physiotherapy and rehabilitation. Your orthopaedic surgeon will work closely with you to develop a tailored rehabilitation plan to help you regain strength and function.


Are there potential complications?

As with any surgical procedure, there are potential risks and complications associated with treating pelvic and acetabular fractures. These may include infection, nerve damage, blood clots, and the development of post-traumatic arthritis. However, the likelihood of such complications can be minimised through careful surgical planning and post-operative care.


Can I return to normal activities after surgery?

The ability to return to normal activities depends on several factors, including the severity of the fracture, the type of surgical intervention, and the individual's commitment to rehabilitation. Some patients may fully regain their previous level of function, while others may have some limitations.




If you’re looking for an expert in pelvic or acetabular surgery after a fracture then please arrange a consultation with Mr Gray via his Top Doctors profile.

By Mr Andrew Gray
Orthopaedic surgery

Mr Andrew Gray is a consultant orthopaedic surgeon based in Newcastle upon Tyne and Middlesborough.  He is a leading orthopaedic and trauma consultant specialist who works at James Cook University Hospital and Friarage Hospitals in Middlesbrough and Northallerton respectively.  He specialises in knee arthroscopy, knee replacement and knee arthritis.  He is also an orthopaedic trauma specialist who focuses on general lower limb trauma and also pelvic and acetabular fractures.  Mr Gray privately practices at Cobalt Hospital (Newcastle) and Tees Valley Hospital (Middlesbrough). His NHS base is South Tees NHS Foundation Trust where he was the clinical director for the trauma and orthopaedic department in the South Tees Trust from 2018 to 2021.

Mr Gray was a founding member of the UK Orthopaedic Trauma Society. He completed his medical and orthopaedic surgical training in Glasgow and Edinburgh before spending a year in Calgary, Canada, where he completed a trauma fellowship in 2008. He has been a practicing consultant within a major trauma centre for the past 14 years. He has over 1000 primary knee replacements on the National joint registry with good results. He is an arthroscopic knee specialist dealing predominantly with meniscal or cartilage tears and knee arthritis. Furthermore, he has an MD with Distinction from the University of Edinburgh.

Mr Gray is a respected name in research and has published in various peer-reviewed journals. He was the lower limb editor for the journal 'Injury' between 2014 and 2021. He is the co-chair of the recently-formed Fracture Liaison Service Academy Network (FAN) at his NHS trust, which aims to make these services more effective   And has an interest in secondary fracture prevention which involves the management of osteoporosis and fragility fractures.

Mr Gray also teaches on a regular basis, both nationally and is a faculty member for AO courses, and is the principal investigator for various NIHR trauma portfolio studies. He is the Global treasurer and UK secretary for the Fragility Facture Network (FFN) and is the orthopaedic trauma representative on the Royal Osteoporosis Society's clinical and scientific committee.

He is a member of the UK Orthopaedic Trauma Society, the British Orthopaedic Association and a fellow of the Royal College of Surgeons (FRCS (Tr&Orth))

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