Department of Trauma Surgery, Hannover Medical School, Hannover, Germany.
University Hospital, Johannes Wesling Hospital, Minden, Germany.
Arch Orthop Trauma Surg. 2024 Oct;144(10):4655-4665. doi: 10.1007/s00402-024-05599-6. Epub 2024 Oct 23.
Acetabular fractures are still challenging fractures. Fracture classification is the basis for understanding these injuries and to gain treatment and to choose a fracture type-based treatment concept. Using a systematic step-wise concept of fracture analysis, based on specific radiographic lines on standard X-rays allow even less experienced surgeons to get a correct classification of the elementary and associated fracture types of Letournel's classification. Algorithmic analysis of the iliopectineal line, (anterior column involvement), ilioischial line (posterior column involvement), presence of a posterior wall fragment, fracture lines involving the iliac wing and inferior ramus, and the spur sign (representing associated both column fractures) allow for approximately 80-90% correct classifications using standard X-rays when integrating these lines into an algorithm. Especially, T-shaped fractures, ABC and ACPHT fractures may be difficult to classify. Thus, advanced imaging, such as CT scans with multiplanar reconstruction and 3D reconstructions is additionally recommended.
髋臼骨折仍然是具有挑战性的骨折。骨折分类是理解这些损伤并获得治疗以及选择基于骨折类型的治疗概念的基础。使用基于标准 X 射线的特定射线的系统逐步骨折分析概念，甚至可以让经验较少的外科医生正确分类 Letournel 分类的基本和相关骨折类型。对髂耻线（前柱受累）、髂坐骨线（后柱受累）、后壁骨折块存在、累及髂骨翼和下支的骨折线以及刺状征（代表相关的双柱骨折）的算法分析，当将这些线整合到算法中时，使用标准 X 射线可以进行大约 80-90%的正确分类。特别是 T 形骨折、ABC 和 ACPHT 骨折可能难以分类。因此，建议额外使用 CT 扫描多平面重建和 3D 重建等高级成像。
