In acetabular fracture classification (Judet-Letournel), a posterior wall fracture combined with posterior column fracture results in which classification?

• A Associated both-column fracture
• B T-shaped fracture
• C Posterior column and posterior wall fracture ✓
• D Transverse plus posterior wall fracture

Explanation

The Judet-Letournel classification divides acetabular fractures into 5 elementary (anterior wall, anterior column, posterior wall, posterior column, transverse) and 5 associated types. A posterior wall fracture + posterior column fracture = 'posterior column and posterior wall fracture' — a distinct associated pattern approached via the Kocher-Langenbeck approach. This differs from a transverse + posterior wall fracture (transverse fracture through the acetabulum at the level of the quadrilateral plate combined with posterior wall fragment). Associated both-column fracture is when both anterior and posterior columns are fractured with no articular surface remaining attached to the ilium ('spur sign' on CT).

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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