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Updated: Jun 28, 2025
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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
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Unclassified acetabular fractures: Do they really exist?
Mohammad Kamal Abdelnasser1, Bahaaeldin Ibrahim2,3, Mostafa A Thabet2
1Orthopedic Department, Assiut University Hospital, Assiut, Egypt. Abdelnasser.m.k@aun.edu.eg.
Summary
The Letournel classification for acetabular fractures is not fully inclusive, with 9.3% of fractures in this study being unclassifiable. These rare patterns may necessitate specialized treatment approaches.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Radiology
Background:
- The Letournel classification is the standard for acetabular fractures.
- However, some acetabular fractures do not fit existing categories.
- This study investigates these unclassified fractures.
Purpose of the Study:
- To determine the incidence of unclassified acetabular fractures.
- To describe the patterns of these rare fractures.
- To explain why they are considered unclassifiable within the Letournel system.
Main Methods:
- Retrospective consecutive case series.
- 236 acetabular fractures from 2016-2017 reviewed.
- Classification by two surgeons, with senior author resolving discrepancies.
Main Results:
- 22 out of 236 fractures (9.3%) were unclassifiable by Letournel criteria.
- Identified patterns included pure quadrilateral plate, labral avulsion, articular impaction, and combined fractures.
- The most common unclassified pattern was 'T with posterior wall' (63.8% of unclassified cases).
Conclusions:
- Several acetabular fracture patterns fall outside the Letournel classification.
- These unique fractures may require tailored surgical approaches and fixation techniques.
- Modifications or subclassification of the Letournel system could accommodate these patterns.
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