Review Question - QID 759

There are 5 simple and 5 associated fracture types according to the classification system created by Judet and Letournel. The key feature which distinguishes both column fractures from other associated types is that all articular segments are detached from the intact portion of the ilium, which remains attached to the sacrum through the SI joint.

Although the transverse plus posterior wall, T-shaped, and anterior plus posterior hemi-transverse fractures all show involvement of the anterior and posterior columns, they are not “both columns” because a portion of the articular surface remains in its normal position, attached to intact ilium.

The intact ilium is responsible for the "spur sign" noted most prominently on the obturator oblique radiograph.

Illustration A demonstrates the 10 types of acetabular fractures as created by Judet and Letournel. Illustration B is an example of a both column acetabular fractures as seen on the obturator oblique radiograph.