The Judet and Letournel classification of acetabular fractures identifies 10 fracture types. A fracture that involves the anterior column, posterior column, and the quadrilateral plate with disruption of both columns from the iliac wing is termed:
- A Both-column fracture (complete articular fracture) ✓
- B T-type fracture
- C Transverse fracture
- D Anterior column + posterior hemitransverse fracture
Explanation
The both-column fracture (bicolumn fracture) is the most common acetabular fracture (approximately 23%) and the only type in which no portion of the articular surface remains attached to the innominate bone — it is a 'floating acetabulum.' The pathognomonic radiographic sign is the spur sign on the obturator oblique view, representing the intact posterior ilium. Because the acetabular dome is entirely detached, non-operative management may still succeed if secondary congruence (fracture impaction and self-reduction) occurs. Surgical ORIF through combined approaches is required if secondary congruence is not achieved.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.