The first known descriptions of surgical fixation of acetabular fractures were case reports in 1943. Fractures of the acetabulum ebook by emile letournel. In december 1961, letournel 10 published his original series on acetabular fracture classification and operative management. Mar 16, 2019 acetabular fractures are fractures that extend into the hip joint and pose a challenge for orthopaedic trauma surgeons. There is substantial interobserver agreement for letournel acetabular fracture classification with multiplanar reformatted and 3d multidetector ct images. An acetabular fracture occurs when the socket of the hip joint is broken. Acetabulum fractures need evaluation comprehensively by xrays and ct scans. Subchondral fracture of the femoral head after acetabular. Such treatment demands an exact reconstitution of the anatomy of the acetabulum and pelvic bone. Such treatment demands an exact reconstitution of the.
By emile letournel, robert judet fractures of the acetabulum by emile letournel, robert judet at the request of our publishers, i accepted the task of preparing this second edition. Despite dividing fractures into 10 subsets, letournel believed that acetabular fractures represent a spectrum of injury, because incomplete fracture lines and combined fracture patterns were common. A fracture classification system enables communication among surgeons and provides guidelines for treatment as well as some estimate of prognosis. Letournels system1981 classifies acetabular fractures into 10 major fracture patterns. View or download all content the institution has subscribed to. Fractures of the pelvis and acetabulum download ebook pdf. Fractures were classified according to the classification of letournel. Letournal and judet classification of acetabular fracture is widely used.
Judetletournel acetabular fractures classification elementary. We report a case of posttraumatic osteoarthritis after. 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. Outcomes after surgical treatment of acetabular fractures. Letournel classification for acetabular fractures orthobullets. This is much less common than most hip fractures, where the top of the thigh bone is damaged, not the socket. This is the most common variety of acetabular fracture. This site is like a library, use search box in the widget to get ebook that you want. After intensive research into the complex anatomy and radiographic landmarks of the acetabulum, they developed an acetabular fracture classification system that. Within elementary and associated fracture patterns, there are many variations. Demographic changes in industrialized countries come along with an increase in fragility fractures. Acetabulum fractures are less common and occur with an incidence of about three per 100. Nov 03, 2017 mechanisms of injury for acetabulum fractures impact of the femoral head with the acetabular articular surface gtalong the axis of the femoral neck anywhere along the long axis of the femoral shaft.
Get your kindle here, or download a free kindle reading app. The classification is based on the identification of fracture lines on plain radiographs. Standard judet pelvic radiographs add little information for changing the multidetector ct classification. Radiographic analysis and classification of displaced acetabular fractures by letournels classification allows the surgeon to choose better the appropriate surgical approach. Arthritis the biggest long term complication of a broken acetabulum is the development of arthritis. Thus, the system should be anatomically meaningful and reliable.
Radiology not only provides assessment of injury, it helps choose best possible approach for stabilization, if indicated references. 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 second edition was published in 1993 but it is still a greatfully source. Read fractures of the acetabulum by emile letournel available from rakuten kobo. Fractures of the pelvis and acetabulum download ebook. Fractures of the acetabulum by emile letournel, 9783540521891, available at book depository with free delivery worldwide. The judet brothers and, subsequently, emile letournel studied acetabular fractures extensively and were responsible for popularizing the surgical management of these challenging injuries. Complex fractures are more common and are composed of. A new, easy, fast, and reliable method to correctly classify acetabular fractures according to the letournel system. Letournel and judet classification of acetabular fracture is a modification of the original 1964 judet classification. Apr 10, 2017 the complexity of acetabulum fractures has always been challenging to the operating surgeon. Judet and letournel classification for acetabular fractures. Pdf a new, easy, fast, and reliable method to correctly classify.
These kind of fractures are uncommon in elderly patients, but lately the number is increasing. The letourneljudet classification system is the standard classification for acetabular fractures. Screw fixation of acpht acetabular fractures offers. Classification and surgical approaches for open reduction. An acetabular fracture is mostly caused by a traumatic accident, such as a motor vehicle or a bad fall, and affects often the younger population. Acetabular fractures archives trauma international. Fractures of the extremities, head injuries, chest, abdomen and pelvic ring injuries are the most commonly associated injuries 1. 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. The complexity of acetabulum fractures has always been challenging to the operating surgeon. As a result of his work in this area, major advances have occurred in the surgical techniques used to reduce and fix difficult fractures of the acetabulum.
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. Several systems are available for the classification of acetabular fractures arbeitsgemeinschaft fur osteosynthesefragen ao, harris, etc. A study on fracture lines of the quadrilateral plate based on fracture. Figure 1 group a received thirty minutes of training, with the presentation of a methodology for the classification of acetabular fractures guided by the authors. He has described everything which related acetabular fractures, xrays, results of the operative treatment, aproaches etc. General principles of management of acetabular fractures. Pdf controversies in treatment of acetabular fracture. Mechanisms of injury for acetabulum fractures impact of the femoral head with the acetabular articular surface gtalong the axis of the femoral neck anywhere along the long axis of the femoral shaft. Comprehension and reproducibility of the judet and. The purpose of this study was to assess the interobserver and intraobserver reliability of letournel s acetabular fracture classification and the effect of computed. Evaluation of letournel and judet classification of. At the time of the original description, acetabular fractures were not commonly treated with open surgery, often leading to pain and posttraumatic.
For example, the bone can break straight across the socket or shatter into many pieces. Please mention that you will be attending the letournel course. Elementary fracture description associated fractures description posterior wall. Surgical treatment for bothcolumn acetabular fractures usin. The combination of impaired bone quality and a loss of postural stability frequently 2, 3 results in geriatric lowenergy fractures also of the acetabulum, typically judet and letournel type anterior column posterior hemitransverse fractures acpht. Interobserver agreement for letournel acetabular fracture. The letournel judet classification system is the standard classification for acetabular fractures. Both groups, already familiar with the judet and letournel classification system for acetabular fractures, received a spreadsheet with descriptive images of all the subtypes. Nov 28, 2018 fractures of the acetabulum were treated nonoperatively until the middle of the 20th century. Fractures of the acetabulum classification of judet and letournel. It classifies acetabular fractures into ten major fracture patterns, which consist of five simple patterns and five complex patterns 1,2.
The judet and letournel classification is the most widely used classification system for acetabular fractures. To retrospectively evaluate interobserver agreement for letournel acetabular fracture classification with radiography alone and multidetector computed tomography ct alone and to retrospectively assess whether standard judet views lead to a change in the classification. According to letournel, an anterior wall fracture also contains the portion of the anterior column anterior to the acetabulum ie, extension through the quadrilateral surface but is different from anterior column fractures in that it leaves a large portion of the anterior column connected to the sciatic buttress fig 9, movie 5. Surgical treatment for bothcolumn acetabular fractures. 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.
Acetabulum fractures can involve one or more of the two columns, two walls or roof within the pelvis. Acetabular fractures can occur in isolation or in combination with other pelvic fractures figures 43 to 51. According to the xray, ct, and operative records of the patients, judetletournel classification was carried out for acetabular fractures involving. Decision making in acetabulum fractures trauma international.
Fractures of the acetabulum occur when the head of the femur is driven into the pelvis. To aid in the classification of acetabular fractures and to aid in. Accidents accidents, traffic acetabulum classification femur head fracture fixation fractures, bone hip joint humans. According to the classification of judet and letournel, representation of acetabular fractures was as follows. Seventeen fractures were treated closed, and 88 were treated operatively. Judet letournel acetabular fractures classification elementary. In 1964, robert judet, jean judet, and emile letournel published a landmark article describing a classification system and surgical approaches to treat acetabular fractures.
Progressive osteoarthritis is considered to be caused by an irregular articular surface of the acetabular roof or cartilage injury, but little is known about the pathogenesis of collapse of the femoral head after acetabular fracture. 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. Surgical treatment of displaced acetabular fractures core. The most widely accepted classification scheme for acetabular fractures is that of judet and letournel 2, 4, 6. Jan 24, 2019 demographic changes in industrialized countries come along with an increase in fragility fractures. Because of judets interest in the management of pelvic fractures, letournel focused his attention on this problem also. Fractures of the acetabulum classification of judet and. Acetabular fractures when combined with fractures of the pelvic ring indicate highenergy trauma, caused by lateral or anteroposterior compression. Acetabular fractures are fractures that extend into the hip joint and pose a challenge for orthopaedic trauma surgeons. In the young patient population, acetabular fractures typically result from highenergy trauma such as a motor vehicle accident and can be associated with hip dislocation.
Fractures of the acetabulum were treated nonoperatively until the middle of the 20th century. Call the fairmont miramar hotel at 3105767777 or 8665404470 for reservations. Letournel and judet classification of acetabular fractures. It divides acetabular fractures into 5 simple patterns and 5 complex patterns. The most common fractures were the complex associated types with 44 complete both column, 19 tshaped, and 18 associated transverse and posterior wall. Fractures of the acetabulum emile letournel springer. It is very rare for both sides of the hip joint to be damaged in an injury. Introductionfractures of the acetabulum generally occur in younger individuals as a result of highenergy motorvehicle accidents. Only then can this complex injury to a complex region be understood. Although letournels classification system provides a framework in which to understand acetabular fractures and plan surgical approaches, it does not address hip stability.
Fractures of the acetabulum can be difficult to recognize on plain xray but are readily evident with ct. Click download or read online button to get fractures of the pelvis and acetabulum book now. It is important that you tell us if you become aware of any of these, because early treatment can be more effective. Nov 09, 20 although letournels classification system provides a framework in which to understand acetabular fractures and plan surgical approaches, it does not address hip stability.
For example, posterior wall acetabular fractures are present in three of 10 fracture patterns. In the past 50 years, following pioneering work by letournel and judet, there is better clarity to the treating surgeon regarding the management of these fractures. Everyday low prices and free delivery on eligible orders. Please book prior to monday, september 8 th, 2014 and we encourage booking your reservation early. It is used to plan treatment and surgical approach. Preventing posttraumatic osteoarthritis is a challenging problem following acetabular fracture. Fractures of the acetabulum emile letournel, robert judet. 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.