Algorithms in Acetabular Fracture Classifications

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2024 Oct 23

PMID 39441365

Authors

Axel Gansslen

Jerome Tonetti

Tim Pohlemann

Affiliations

Soon will be listed here.

Abstract

Acetabular fractures are still challenging fractures. Fracture classification is the basis for understanding these injuries and to gain treatment and to choose a fracture type-based treatment concept. Using a systematic step-wise concept of fracture analysis, based on specific radiographic lines on standard X-rays allow even less experienced surgeons to get a correct classification of the elementary and associated fracture types of Letournel's classification. Algorithmic analysis of the iliopectineal line, (anterior column involvement), ilioischial line (posterior column involvement), presence of a posterior wall fragment, fracture lines involving the iliac wing and inferior ramus, and the spur sign (representing associated both column fractures) allow for approximately 80-90% correct classifications using standard X-rays when integrating these lines into an algorithm. Especially, T-shaped fractures, ABC and ACPHT fractures may be difficult to classify. Thus, advanced imaging, such as CT scans with multiplanar reconstruction and 3D reconstructions is additionally recommended.

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