On a radiograph, an acetabular fracture shows the classic 'gull-wing' deformity of the ilioischial line with disruption of both the anterior and posterior columns. The fracture type is:

• A Both-column fracture (associated both-column) ✓
• B Posterior wall fracture
• C T-type acetabular fracture
• D Transverse fracture with posterior wall

Explanation

The both-column fracture (also called 'associated both-column') is the only acetabular fracture in the Letournel classification in which NO articular segment remains attached to the axial skeleton — all articular fragments are free-floating. The ilioischial line is disrupted, and the 'spur sign' (spur of ilium remaining on the intact posterior ilium) on obturator oblique view is pathognomonic. The 'gull-wing' deformity on AP radiograph reflects bilateral column displacement. T-type fractures have a transverse component with a vertical split.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.