Concomitant fractures of the acetabulum and spine: a retrospective review of over 300 patients.

Background: The incidence and spectrum of concomitant acetabulum and spine trauma has not been clearly defined.

Methods: We retrospectively reviewed 307 acetabulum fracture patients over 5 years, and evaluated this cohort for concomitant spine injuries. Patient and injury demographics, spine and neurologic injury and delay in diagnosis were examined.

Results: Complete data were available for 275 (90%) of the cohort, and 55 spine injuries (54 fractures and 1 traumatic disc herniation) were identified in 34 patients. Thus, the incidence of concomitant acetabulum and spine fractures was approximately 13% (34 of 275). Four percent of the patients sustained significant thoracolumbar fractures (burst, flexion-distraction, or dislocation). An average 8.6-day delay in diagnosis occurred in three spine fracture patients. One suffered progressive neurologic injury.

Conclusions: It is essential that the traumatologists have a high index of suspicion for spine injury, particularly thoracolumbar injury in patients who sustain fractures of the acetabulum. We recommend early thoracolumbar computed tomography imaging in patients with fractures of the acetabulum if plain radiographs are not possible or inadequate.