Acetabular fractures revisited: part 2, a new CT-based classification

Area of Science:

• Orthopedic Surgery
• Radiology
• Trauma Care

Background:

• Acetabular fractures are complex injuries requiring precise classification for effective treatment.
• Existing classification systems may lack clarity or comprehensive detail for surgical planning.

Purpose of the Study:

• To introduce a novel computed tomography (CT)-based classification system for acetabular fractures.
• To establish a simple and unambiguous system for diagnosis and surgical treatment planning.

Main Methods:

• Analysis of axial CT scans from 112 acetabular fractures.
• Inclusion of 3D reformatted images when available.
• Fracture patterns were assessed based on column involvement and extension beyond the acetabulum.

Main Results:

• A four-category classification (0-III) was established for acetabular fractures.
• Category 0: wall fractures only. Category I: single column involvement.
• Category II: both columns involved (with subcategories for extension). Category III: "floating" acetabulum.

Conclusions:

• The proposed CT-based classification is simple, unambiguous, and easily understood by radiologists and orthopedic surgeons.
• This system provides clear guidance for diagnosis and surgical treatment planning of acetabular fractures.
• Specific categories and subcategories facilitate postoperative assessment of fracture types.