Learning objectives
To demonstrate the importance for the radiologist of being familiar with the classification of acetabular fractures (AF);
To describe the spectrum of radiographic findings in AF,
focusing on the main acetabular landmarks;
To establish the role of CT in defining AF.
Background
To provide value-added service,
the radiologist must interpret and describe AF using high-quality radiographs and CT scans,
reviewed together.
The Judet-Letournel classification system is the most widely used and reported system for acetabular fractures (AF) evaluation [1,
2].
Judet and Letournel divided AF in two groups,
elementary (posterior wall,
posterior column,
anterior wall,
anterior column,
transverse) and complex (T shaped,
posterior column and wall,
transverse and posterior,
anterior and posterior hemitransverse,
both columns); each has its subgroups and between the different groups exist the transitional...
Findings and procedure details
Radiography
AF are primary evaluated with the anteroposterior (AP) (Fig. 1 a,
b) and Judet views (Fig. 1 c-f),
as they are able to demonstrate the following radiographic landmarks of each acetabular column: the anterior and posterior acetabular walls and the iliopectineal and ilioischial lines [1,
2,
5,
6] (Fig. 1).
CT
CT is considered the reference standard for showing AF [7].
The new generation CT scanners with multiplanar reconstructions (MPR) and three-dimensional (3D) volume rendered images represent a more valuable visual tool for defining...
Conclusion
Although AP and Judet views,
which show the major radiographic landmarks of each acetabular column,
generally diagnose and classify AF [1],
CT is superior in revealing exact fracture pathologic configuration,
impacted or incarcerated fragments,
hip joint residual congruence,
or associated lesions [11,
12]; 3D reconstructions of CT data are a more valuable visual tool for defining AF,
especially complex displaced fractures for which mental reconstruction of the axial sections into a 3D configuration is a time-consuming effort [11,
13,
14].
In conclusion,
it is the...
Personal information
V.
Zecchi,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo A.
Gemelli 8,
00168,
Rome/Italy.
A.
Leone,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo A.
Gemelli 8,
00168,
Rome/Italy.
A.
Semprini,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo A.
Gemelli 8,
00168,
Rome/Italy.
M.
Marino,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo A.
Gemelli 8,
00168,
Rome/Italy.
L.
Tonetti,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo A.
Gemelli 8,
00168,
Rome/Italy.
C.
Colosimo,
Instituteof Radiology,
Catholic University,
School of Medicine,
Largo...
References
[1] Letournel E.
Acetabulum Fractures: Classification and Management.
Clinical Orthopaedics and Related Research.
1980;151:81-106.
[2] Letournel E,
Judet R.
Fractures of Acetabulum.
2nd Ed.
New York,
Springer Verlag; 1981.
[3] Lawrence DA,
Menn K,
Baumgaertner M,
Haims AH.
Acetabular fractures: anatomic and clinical considerations.
AJR Am J Roentgenol 2013;201(3):W425–W436.
[4] Reilly MC.
Fractures of the acetabulum.
In: Bucholz RW,
Heckman JD,
Court-Brown C,
eds.
Rockwood and Green’s fractures in adults.
6th ed.
Philadelphia,
Pa: Lippincott Williams & Wilkins,
2006;1665–1714.
[5] Durkee NJ,
Jacobson J,
Jamadar...