[Therapeutic dilemmas in the care of acetabular fractures]

Breakages of acetabulum take special place in traumatism of pelvis luxation breakages of acetabulum are serious wound, which are followed by traumatic shock. Such wounds are hard medical-surgical problem what puts traumatology surgeon in dilemma how to look after the same. Etiologic fact of these breakages in 90% is direct or indirect accident trauma. In our work we demonstrate the mechanism of becoming of such breakage and after that we give classification of fracture and luxational-breakages of the acetabulum. The meaning of radiographically diagnostics in marking out fragments the place of the head of femur operating indication and with which approaching. The central place in the work takes empirical results of treating of 56 patients in the period of April 1975 to 31 st of March 1980 on Traumatological-orthopaedic Department to Common City Hospital in Skopje. The meaning of the surgeons about surgical treatment of breakage of acetabulum are still divided. We give algorithm of surgical treatment of breakage of acetaleulum. We present surgical approaching and surgical methods in those breakages. We'll explain three times meaning of biomechanical splint "Hornik" Dr Nikodinovski own model in postoperative treating so as in conservative treatment in luxational breakages of the acetabulum. Out attitudes are surgical reconstruction and fixation to young patients with early activating. We give rights double tractin to the old patients. We'll show post-traumatic and post surgical late sequelae of these breakages as they aseptical necrose of head of femur and coxatrose that go to 35%.