• Michael Leunig, John B Sledge, Thomas J Gill, and Reinhold Ganz.
• Department of Orthopedic Surgery, University of Berne, Inselspital, CH-3010 Berne, Switzerland. michael.leunig@insel.ch
• Arch Orthop Trauma Surg. 2003 Oct 1; 123 (8): 392-5.

IntroductionDuring the treatment of a malunited transverse acetabular fracture, a hitherto undescribed extended avulsion of the labrum from the stable acetabular fragment was found. Based on the labral pathomorphology present in this case, the hypothesis was put forward that traumatic acetabular labral avulsions are a constant phenomenon in transverse acetabular fractures.Patients And MethodsFourteen patients underwent capsulotomy and/or surgical dislocation of the involved hip to facilitate open reduction and internal fixation of transverse acetabular fractures.ResultsIn all cases, the labrum was partially or completely detached from the superior acetabular rim. In eight cases with bucket-handle tears of the labrum from the stable superior fragment, the injured portion was resected back to normal margins. In one case the labrum was avulsed with an attached piece of bone and was repaired by screw fixation. Small separations of the labrum from the underlying acetabular rim occurred at the level of the fractures in five cases with minor displacement and received no treatment.ConclusionWith displaced transverse acetabular fractures, consideration should be given to opening the joint at the time of open reduction and internal fixation to look for associated intracapsular injuries. An avulsed portion of the labrum should be left if stable and undamaged. If unstable and damaged, it is probably better resected and if unstable but intact and/or attached to a bony fragment, it should be repaired.

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