CPT® Code 27228

Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation

The CPT® Code 27228 pertains to the open treatment of complex acetabular fractures that involve both the anterior and posterior columns of the acetabulum. The acetabulum is a critical component of the hip joint, consisting of several anatomical structures, including the anterior (iliopubic) column, posterior (ilioischial) column, anterior wall, posterior wall, quadrilateral plate (medial wall), and dome. This code specifically addresses fractures that are more intricate than simple fractures, as they involve multiple fracture lines that can significantly compromise the stability and function of the hip joint. A two-column fracture, often referred to as a floating acetabular fracture, occurs when fracture lines extend into both the ilioischial line posteriorly and the iliopubic segment anteriorly, leading to a complete separation of the acetabulum from the iliac wing. Additionally, T-fractures are characterized by a transverse fracture accompanied by another fracture line that disrupts the quadrilateral surface, resulting in the separation of the anterior and posterior columns. The complexity of these fractures necessitates a surgical approach to ensure proper alignment and stabilization. The procedure involves making an incision over the hip joint to expose the fracture sites, followed by debridement and irrigation of the joint to remove any loose fragments. The fractured areas are then reduced, and anatomic alignment is confirmed through radiographic imaging before applying permanent fixation devices, which may include lag screws and plates. This comprehensive approach is essential for restoring the structural integrity of the acetabulum and facilitating optimal recovery and function of the hip joint.