Acetabular pelvic fractures

Background

• Fractures usually occur when head of femur forced into acetabulum
• Obvious when displaced, subtle non-displaced

Radiographically

• Iliopubic line extends from ilium to superior pubic ramus
• Ilioischial line- extends from ilium to ischial ramus forming radiographic teardrop, "U" shaped, on AP pelvis
• Quadrilateral plate forms medial wall of acetabulum

Anatomy

• Anterior column-anterior acetabulum to pubic ramus
• Posterior column- posterior acetabulum to ischial ramus
• Anterior and posterior columns merge to form acetabular dome= weight bearing portion
  • Fractures involving acetabular dome require operative fixation

Fractures

• Anterior column
• Posterior column
• Transverse
• T or Y-shaped
• Posterior rim
• Anterior Wall