Acetabular pelvic fractures


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


  • 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

Clinical Features

  • Pelvic pain after trauma (low energy for elderly, high energy for young)

Differential Diagnosis

Hip pain



  • Consider obtaining AP, Judet, and inlet/outlet films
  • 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
Acetabular fracture (red arrow)
Right acetabular fracture (arrow)

Fractures Types

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


  • Early ortho consultation and hospital admission is indicated for all


  • Admission

See Also