Fractures of the acetabulum emile letournel springer. Fractures of the acetabulum classification of judet and letournel orthopaedicsone articles. This zone is situated below and in front ofthe iliac articular surface ofthe sacroiliacjoint. Get your kindle here, or download a free kindle reading app. Acetabulum fractures occur when a highimpact blunt force is transmitted through the femoral head.
The judet and letournel acetabular fracture classification system, based on the idea of bicolumnar support of the acetabulum, was first described in a landmark article published in the 1960s. Numerous and frequentlyupdated resource results are available from this search. It should be carried out by experienced surgical team to get best results. The classification system of judet and letournel has led to improved management of such injuries. For example, the bone can break straight across the socket or shatter into many pieces.
Radiographic analysis and classification of displaced acetabular fractures by letournels classification allows the surgeon to choose better the appropriate surgical approach. Acetabular fractures in the elderly population are marked by a high degree of variability in terms of patient and fracture characteristics. Acetabulum fracture an overview sciencedirect topics. It is very rare for both sides of the hip joint to be damaged in an injury. Furthermore, the judet and letournel system is complicated and easily misunderstood, reflecting the nature of the anatomy itself.
The judet and letournel classification is the most widely used classification system for acetabular fractures. The most widely accepted classification scheme for acetabular fractures is that of judet and letournel 2, 4, 6. The classification scheme developed by judet et al. Judetletournel acetabular fractures classification elementary. Ebraheims educational animated video describes fractures of the acetabulum types. Such treatment demands an exact reconstitution of the anatomy of the acetabulum and pelvic bone. In 1964, french surgeons robertt judet, jean judet, and emile letournel first described the mechanism, classification, and treatment of acetabular fracture. Fractures of the pelvis and acetabulum by marvin tile and a great selection of related books, art and collectibles available now at. Acetabulum fracture classification associated types ota. This injury is caused by a blow to either the side or front of the knee and often occurs as a dashboard injury accompanied by a fracture of the femur the acetabulum is a cavity situated on the outer surface of the hip bone, also called the coxal bone or innominate bone. The series consists of 96 patients, 82 males and 14. Clinical and radiological assessment of acetabular fracture.
Such treatment demands an exact reconstitution of the. When the acetabulum is fractured, the femoral head may no longer fit firmly into the socket, and the cartilage surface of both bones may be damaged. The socket part is lined with smooth cartilage and is called the acetabulum, which is part of the pelvis. The discrepancy between the letournel definition of the anterior and posterior columns became readily apparent. Although letournels classification system provides a framework in which to understand acetabular fractures and plan surgical approaches, it does not address hip stability. History and development of our methods of classification and treatment of acetabular fractures. Fractures of the acetabulum by emile letournel, 9783540521891, available at book depository with free delivery worldwide. When the socket is fractured, it is called an acetabular fracture. Successful outcomes depend on application of highly. Fractures of the acetabulum occur when the head of the femur is driven into the pelvis.
Introductionfractures of the acetabulum generally occur in younger individuals as a result of highenergy motorvehicle accidents. Acetabulum fracture types everything you need to know. Read fractures of the acetabulum by emile letournel available from rakuten kobo. Decision making in acetabulum fractures trauma international. For example, posterior wall acetabular fractures are present in three of 10 fracture patterns. Fractures of the acetabulum classification of judet and. The relevance of the judet and letournel acetabular. Your fractured acetabulum a guide for patients about the injury and post operative recovery trauma and orthopaedics department. Standard text books of anatomy and surgical anatomy were referenced relative to. When available, 3d reformatted images were analyzed as well. Fractures of the acetabulum ebook by emile letournel.
It classifies acetabular fractures into ten major fracture patterns, which consist of five simple patterns and five complex patterns 1,2. Reginald a elson this book was written to help orthopaedic and trauma surgeons understand andtreat acetabular fractures, laying out a method of reading both plain radiographs and ct scans. The femoral head acts like a hammer and is the last link in the chain of forces transmitted from the greater trochanter, knee, or foot to the acetabulum. Twentytwo years of experience in this field allow us to say that a perfect open reduction is the method of choice to treat displaced acetabular. An acetabular fracture occurs when the socket of the hip joint is broken.
The most common classification used for acetabular fractures is the judetletournel classification. This is much less common than most hip fractures, where the top of the thigh bone is damaged, not the socket. Above all, i thought it was time to report the longterm results of the 940 acetabular fractures, 90070 of which were treated surgically a unique series. Acetabular fractures are a challenging topic for radiologists and orthopedists. This article gives an insight to the reader regarding the basic principles regarding the decision making to treat acetabulum fractures operatively or nonoperatively. Plate osteosynthesis is the most widely applied stabilization method for all fracture types. Acetabular fractures are typically highenergy injuries and are often associated with insults to other major organ systems up to 50%. The posterior or ilioischial column which is voluminous and thick descends caudad as far as the ischial tuberosity. Judet and letournel classification for acetabular fractures. The importance of 3 dimensional ct images and usefulness of the roof arc angles in making decisions to. Both letournel and matta have definitively shown that anatomic reduction of the fracture is the most influential factor predictive of clinical outcome. Fractures of the acetabulum occur as a result of the force exerted through the head of the femur to the acetabulum. Reliable information about the coronavirus covid19 is available from the world health organization current situation, international travel. Judet preface to the french edition it is a long time since we first attempted surgical treatment of fractures of the acetabulum accompanied by displacement, with the aim of restoring perfect articulation.
Historically, these injuries were treated nonoperatively due to the complexity of the fracture and difficult surgical exposure. Oclcs webjunction has pulled together information and resources to assist library staff as they consider how to handle coronavirus. Judet and letournel were disappointed with both operative and nonoperative outcomes of acetabular fractures, so in the 1960s they developed standardized imaging protocols with which to classify acetabular fractures. Fractures of the acetabulum may occur with or without disruption of the pelvic ring. Fractures in this area should therefore also be repaired surgically, although conservative treatment of fractures of the caudal acetabulum is sometimes suggested.
Accidents accidents, traffic acetabulum classification femur head fracture fixation fractures, bone hip joint humans. Each fracture type is further divided into three fracture groups a1, a2, a3, b1, b2, b3, c1, c2, c3, according to its proposed increasing fracture severity. Such fractures are far less common than fractures to the ball part of the joint. The most widely used classification of acetabular fractures is the letournel classification which is a modification of the 1964 judet anatomic classification. All these 3 segments meet at the triradiate cartilage or a yshaped synchondrosis centered on the acetabulum. The letournel extention of the ilioinguinal approach was modified with. Narrated, annotated lecture 4 of 4 on associated acetabulum types by judetletournal classification from the ota resident lecture series narrated by. After intensive research into the complex anatomy and radiographic landmarks of the acetabulum, they developed an acetabular fracture classification system that. Outcomes after surgical treatment of acetabular fractures. Pdf controversies in treatment of acetabular fracture. Type c fractures represent all types of bothcolumn fractures. Moed br, letournel e 1993 combination lowdose radiation and indomethacin therapy for the prevention of heterotopic ossification following acetabular fracture surgery. Letournel and judet 1993, in the largest series of operatively treated acetabular fractures, followed this same principle. Resources on fractures of the acetabulum classification of judet and letournel and related topics in orthopaedicsone spaces.
At the request of our publishers, i accepted the task of preparing this second edition. Acetabular fractures or pelvis fractures are among the most serious injuries that require being treated by the orthopedic surgeons. Posterior wall fracture posterior column fracture transverse fracture anterior column fracture anterior wall fracture assoc. Although this classification scheme describes 10 types of acetabular fractures, we have focused on the most common fracture patterns, which represent 90% of acetabular fractures 2, 6 figs. It has stood the test of time and continues to be the preferred method for describing acetabular fractures for the majority of orthopaedic trauma surgeons. Classification of acetabulum fractures musculoskeletal key. Acetabulum forms from 3 ossification centers known as the ilium, ischium and the pubis. Judet preface to the french edition it is a long time since we first attempted surgical treatment of fractures of the acetabulum accompanied by.