Surgical treatment of acetabulum top compression fracture with sea gull sign

To investigate surgical procedures and their efficacy for acetabulum top compression fractures with sea gull sign.

Data of 14 patients (five women, nine men); aged from 28 to 71 years (mean, 49.9 years) who had undergone surgery for acetabulum top compression fractures with sea gull sign and been followed up were retrospectively analyzed. The time from injury to surgery was 4-14 days (mean, 9 days). All patients underwent open reduction and bone graft and internal fixation through an ilioinguinal or ilioinguinal plus Kocher-Langenbeck approach. Quality of fracture reduction was assessed according to Matta reduction criteria and hip function according to Matta acetabular fracture criteria.

Fourteen patients were followed up for 6-60 months (mean, 36 months). All achieved bone healing within 3-4 months (mean, 3.4 months); the excellent and good rate being 78.5% (11/14). The Matta acetabular fracture scores were 10-18 scores (mean, 16.4); the excellent and good rate being 71.4% (10/14). Traumatic arthritis occurred in three patients. Pain was serious in two patients and relieved by total hip joint replacement and mild in one. One patient developed asymptomatic heterotopic ossification postoperatively.

The appropriate delay between injury and surgery with acetabular roof compression fracture with sea gull sign is from 5 to 10 days. Through an ilioinguinal or ilioinguinal plus Kocher-Langenbeck approach, excellent reduction of the articular surface can be achieved and sufficient bone graft material obtained. The clinical efficacy is satisfactory.