In Judet and Letournel acetabular fracture classification, a posterior column fracture differs from a posterior wall fracture in that it:

• A Involves only the posterior cortex without disrupting the ilioischial line
• B Always produces an unstable hip dislocation requiring immediate reduction
• C Disrupts the ilioischial line (posterior column) and extends from the sciatic notch to the ischiopubic ramus ✓
• D Is treated conservatively with traction, unlike a posterior wall fracture

Explanation

The posterior column is the structural unit from the superior sciatic notch down through the posterior acetabular dome, posterior wall, and ischiopubic ramus; fracture disrupts the ilioischial line on obturator oblique view. A posterior wall fracture is limited to the posterior articular rim without a column fracture and does not disrupt the ilioischial line. Both may be associated with dislocation. Surgical management is generally recommended for displaced posterior column fractures affecting weight-bearing dome.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.