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Review Question - QID 2925

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QID 2925 (Type "2925" in App Search)
A 33-year-old male sustains the injury seen in Figure A as a result of a high-speed motor vehicle collision. Based on this image, what is the most likely acetabular fracture pattern?
  • A

Both column

33%

631/1929

Anterior column

1%

27/1929

Anterior column posterior hemitransverse

5%

96/1929

Transverse

57%

1103/1929

T-type

3%

65/1929

  • A

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The radiograph in Figure A shows a transverse acetabulum fracture. The iliopectineal (anterior column) and ilioischial lines (posterior column) are interrupted, revealing bicolumnar involvement; however, this is different than the both column fracture, as a transverse pattern has articular surface still in continuity with the axial skeleton via the sacroiliac joint.

The referenced article by Patel et al showed a wide variation of inter and intra-observer agreement in interpreting radiographs of acetabular fractures, with high agreement for basic radiographic classification and only slight to moderate agreement for other radiologic variables such as impaction.

The other referenced article by Letournel is a great review article regarding the initial classification of these fractures as well as a quick summary of his outcomes.

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