Acetabulum
Classifications
The Letournel classification of acetabular fractures 289
The Müller AO Classification 290
Introduction
15.1 Acetabulum—introduction Zhiyong Hou, Wade R Smith, Kaan Irgit 293
1 Introduction 293
1.1 General principles and aims of treatment 293
1.2 Indications and contraindications for MIO 293
2 Surgical anatomy 294
2.1 Special aspects for acetabulum 294
3 Preoperative assessment 294
3.1 Fracture and soft-tissue assessment 294
3.2 Type of x-rays and CT scans 295
3.3 Timing of surgery 297
3.4 Preoperative planning 297
4 Operating room setup 297
4.1 Anesthesia 297
4.2 Role of computer-assisted navigation 297
4.3 Role of endoscopic-assisted surgery 297
4.4 Implants and instruments 297
5 Operative procedure 298
5.1 Patient and image intensifier positioning 298
5.2 Surgical approach 299
5.3 Reduction techniques 301
5.4 Fixation techniques 302
5.5 Intraoperative evaluation of the quality of reduction and positioning of implants 304
6 Postoperative treatment 305
7 Complications 305
7.1 Salvage in failed MIO 305
8 Tips and tricks for minimally invasive techniques 305
9 The future 305
10 References 306
Cases
15.2 Pelvis, acetabulum: a minimally displaced fracture of the right anterior column—62-A3 Zhiyong Hou, Wade R Smith 307
15.3 Pelvis, acetabulum: a minimally displaced transverse fracture of the right acetabulum—62-B1 Zhiyong Hou, Wade R Smith 311
15.4 Pelvis, acetabulum: displaced right T-type acetabular fracture—62-B2, and associated bilateral sacral fractures and left iliac wing fracture Zhiyong Hou, Wade R Smith 317
15.5 Pelvis, acetabulum: minimally displaced right anterior column and posterior hemitransverse acetabular fracture—62-B3 Zhiyong Hou, Wade R Smith 321
15.6 Pelvis, acetabulum: both-column acetabular fracture—62-C2 and C7 body fracture Zhiyong Hou, Wade R Smith 325
Classifications
Acetabular fractures are classified most commonly by the system of Letournel and Judet [ 1]. This classification system was designed to guide the decision of which surgical exposure should be used to treat a particular acetabular fracture. The system is divided into five simple (elementary) and five complex (associated) fracture patterns. The grouping of the five simple fracture patterns is the anterior wall, posterior wall, anterior column, posterior column, and transverse. Of the simple fracture patterns, the transverse is the only one which disrupts both the anterior and posterior columns. All the simple patterns involve fracture in only one plane.
The Letournel classification of acetabular fractures [ 2]
Elementary fractures
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