Acetabular Fracture

Acetabular Fracture

An often complex fracture which can be divided into two broad clinical groups based on the patient’s age and energy of impact, with high energy fractures being more common in younger patients and often linked to vehicular accidents and low energy fractures occurring in older patients. The acetabulum is anatomically comprised of two columns (anterior and posterior) and two walls (anterior and posterior); these form the basis of fracture anatomy which Letournel and Judet divided into:
Simple (elementary) type
Anterior wall
Anterior column
Posterior wall
Posterior column
Transverse
Associated types
T-shaped
Anterior wall/column plus posterior hemitransverse
Transverse plus posterior wall
Posterior column plus posterior wall
Both-columns
Classification The Universal Comprehensive Classification has received the approval of the International Society of Orthopaedic Surgery and Traumatology (SICOT) and other bodies and can be used to compare cases at different centres.
Management Integrity of the joint is essential to minimise future dysfunction; if closed reduction fails, open reduction is required and entails anatomic reduction, which is not always successful.