Primary total hip with acute acetabular fracture. A, Elderly man with mild preexisting arthritis of hip had moderately comminuted T-type fracture of acetabulum. B, CT scan showing comminution of weight-bearing area of acetabular dome. C, Fracture was fixed with lag screws and figure-of-eight braided cable. Primary total hip accomplished with cementless acetabular component fixed with multiple screws. Fracture is united, implants are well positioned, and fixation is stable.