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Acetabular Fracture
Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Fracture involving articular surface of acetabulum
            • Anterior column: Portion of innominate bone extending from anterior superior iliac spine to pubic symphysis and inferior pubic ramus
              • Delimited on radiographs by iliopubic (a.k.a. iliopectineal) line
            • Posterior column: Portion of innominate bone extending from posterior superior iliac spine to inferior pubic ramus
              • Delimited on radiographs by ilioischial line
            • Anterior, posterior walls: Form cup-shape surrounding superior portion of femoral head
              • Technically part of their respective columns, but usually considered separately for purposes of fracture classification
            • Anterior, posterior rims: Margins of acetabular walls
            • Sciatic buttress: Bony continuity from sacroiliac joint (SIJ) to acetabulum
              • Links weight-bearing functions of acetabulum to axial skeleton
            • Quadrilateral plate = medial wall of acetabulum

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Scheinfeld MH et al: Acetabular fractures: what radiologists should know and how 3D CT can aid classification. Radiographics. 35(2):555-77, 2015
                                      2. Amorosa LF et al: High-energy pediatric pelvic and acetabular fractures. Orthop Clin North Am. 45(4):483-500, 2014
                                      3. de Palma L et al: Outcome of unstable isolated fractures of the posterior acetabular wall associated with hip dislocation. Eur J Orthop Surg Traumatol. Epub ahead of print, 2013
                                      4. Dunet B et al: Acetabular fracture: long-term follow-up and factors associated with secondary implantation of total hip arthroplasty. Orthop Traumatol Surg Res. 99(3):281-90, 2013
                                      5. Ferguson TA et al: Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 92(2):250-7, 2010
                                      6. Keel MJ et al: Surgical dislocation of the hip for a locked traumatic posterior dislocation with associated femoral neck and acetabular fractures. J Bone Joint Surg Br. 92(3):442-6, 2010
                                      7. O'Toole RV et al: Evaluation of computed tomography for determining the diagnosis of acetabular fractures. J Orthop Trauma. 24(5):284-90, 2010
                                      8. Giannoudis PV et al: Factors determining quality of life and level of sporting activity after internal fixation of an isolated acetabular fracture. J Bone Joint Surg Br. 91(10):1354-9, 2009
                                      9. Durkee NJ et al: Classification of common acetabular fractures: radiographic and CT appearances. AJR Am J Roentgenol. 187(4):915-25, 2006
                                      10. Harris JH et al: Acetabular fractures revisited: a new CT-based classification. Semin Musculoskelet Radiol. 9(2):150-60, 2005
                                      11. Laird A et al: Acetabular fractures: a 16-year prospective epidemiological study. J Bone Joint Surg Br. 87(7):969-73, 2005
                                      12. Brandser E et al: Acetabular fractures: easier classification with a systematic approach. AJR Am J Roentgenol. 171(5):1217-28, 1998
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Definitions

                                                • Fracture involving articular surface of acetabulum
                                                • Anterior column: Portion of innominate bone extending from anterior superior iliac spine to pubic symphysis and inferior pubic ramus
                                                  • Delimited on radiographs by iliopubic (a.k.a. iliopectineal) line
                                                • Posterior column: Portion of innominate bone extending from posterior superior iliac spine to inferior pubic ramus
                                                  • Delimited on radiographs by ilioischial line
                                                • Anterior, posterior walls: Form cup-shape surrounding superior portion of femoral head
                                                  • Technically part of their respective columns, but usually considered separately for purposes of fracture classification
                                                • Anterior, posterior rims: Margins of acetabular walls
                                                • Sciatic buttress: Bony continuity from sacroiliac joint (SIJ) to acetabulum
                                                  • Links weight-bearing functions of acetabulum to axial skeleton
                                                • Quadrilateral plate = medial wall of acetabulum

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Scheinfeld MH et al: Acetabular fractures: what radiologists should know and how 3D CT can aid classification. Radiographics. 35(2):555-77, 2015
                                                                          2. Amorosa LF et al: High-energy pediatric pelvic and acetabular fractures. Orthop Clin North Am. 45(4):483-500, 2014
                                                                          3. de Palma L et al: Outcome of unstable isolated fractures of the posterior acetabular wall associated with hip dislocation. Eur J Orthop Surg Traumatol. Epub ahead of print, 2013
                                                                          4. Dunet B et al: Acetabular fracture: long-term follow-up and factors associated with secondary implantation of total hip arthroplasty. Orthop Traumatol Surg Res. 99(3):281-90, 2013
                                                                          5. Ferguson TA et al: Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 92(2):250-7, 2010
                                                                          6. Keel MJ et al: Surgical dislocation of the hip for a locked traumatic posterior dislocation with associated femoral neck and acetabular fractures. J Bone Joint Surg Br. 92(3):442-6, 2010
                                                                          7. O'Toole RV et al: Evaluation of computed tomography for determining the diagnosis of acetabular fractures. J Orthop Trauma. 24(5):284-90, 2010
                                                                          8. Giannoudis PV et al: Factors determining quality of life and level of sporting activity after internal fixation of an isolated acetabular fracture. J Bone Joint Surg Br. 91(10):1354-9, 2009
                                                                          9. Durkee NJ et al: Classification of common acetabular fractures: radiographic and CT appearances. AJR Am J Roentgenol. 187(4):915-25, 2006
                                                                          10. Harris JH et al: Acetabular fractures revisited: a new CT-based classification. Semin Musculoskelet Radiol. 9(2):150-60, 2005
                                                                          11. Laird A et al: Acetabular fractures: a 16-year prospective epidemiological study. J Bone Joint Surg Br. 87(7):969-73, 2005
                                                                          12. Brandser E et al: Acetabular fractures: easier classification with a systematic approach. AJR Am J Roentgenol. 171(5):1217-28, 1998