Primary total hip arthroplasty for treatment of a geriatric acetabulum fracture.

CASE REPORT A 79-year-old woman sustained a left anterior column acetabulum fracture after falling on ice. On initial presentation to the emergency room she was placed in femoral pin traction. The reduction of the acetabulum in traction was not concentric and the femoral head began to migrate centrally. Treatment options, including primary THA after the acetabulum fracture healed, were discussed with the patient. The traction was discontinued at 6 weeks, and the patient was allowed to transfer from the bed to the chair. Three weeks later she was ambulatory with a walker, nonweight bearing on the affected side. When the acetabulum fracture healed, she was advanced to weight bearing as tolerated. No further migration of the femoral head was noted (Figure 1). Surgery was initially planned for when the fracture healed, but at the patient’s request was postponed until 6 months after the initial injury. At surgery, the patient was placed in the lateral decubitus position and a posterior approach