In the Judet-Letournel classification of acetabular fractures, a posterior column fracture with a posterior wall component (associated fracture) is distinguished from a pure posterior wall fracture by:

• A Involvement of the sciatic notch on obturator oblique view
• B Disruption of the ilioischial line on AP pelvis representing posterior column involvement ✓
• C Involvement of the ischiopubic ramus on iliac oblique view
• D Disruption of the acetabular roof (sourcil) only

Explanation

In Judet-Letournel classification, elementary fractures include posterior wall, posterior column, anterior wall, anterior column, and transverse types. Associated fractures involve combinations. The posterior column fracture disrupts the ilioischial line (posterior column) on AP pelvic X-ray, which runs from the greater sciatic notch to the ischial tuberosity. A pure posterior wall fracture disrupts only the dome of the posterior wall without involvement of the ilioischial line. The obturator oblique view shows the posterior wall profile; iliac oblique shows the posterior column.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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