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How to improve the performance of acetabulum fracture diagnoses: investigating the use of three-dimensional CT-scan reconstructions



The classification of acetabular fractures remains a challenge for the junior radiologist, although he is the first line of diagnosis in Emergency Department. The advantages of three-dimensional reconstructions have yet to be evaluated on a large scale.


A total of 212 fractures were classified according to Letournel and Judet by a senior orthopaedic surgeon, a senior radiologist, and a resident radiologist. The CT scans were first analysed in 2D and then a second time using 2D + 3D reconstructions of the acetabulum excluding the femoral head.


3D reconstructions improved correct classification not only for the radiologist resident (+ 5%) but also for senior radiologist and orthopaedist (+ 2 and + 3%). 3D reconstructions also more significantly improved the diagnoses of complex fractures (+ 8.3%) compared to simple fractures (+ 0.4%).


3D reconstructions have improved the routine diagnosis of acetabular fractures, especially for junior radiologist or in cases of complex fractures.

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Authors and Affiliations



All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Marie Faruch Bilfeld, Camille Minet, Nicolas Reina, and Gauthier Gracia. The first draft of the manuscript was written by Camille Minet and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Marie Faruch-Bilfeld.

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• 3D CT with femoral head exclusion improves acetabulum fracture detection and classification.

• 3D CT with femoral head exclusion reconstruction is simple and fast.

• 3D CT femoral head reconstruction is useful for both young radiologists and experienced seniors.

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Minet, C., Reina, N., Gracia, G. et al. How to improve the performance of acetabulum fracture diagnoses: investigating the use of three-dimensional CT-scan reconstructions. Emerg Radiol (2022).

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  • Acetabulum fractures
  • Letournel and Judet classification
  • Three-dimensional CT-scan reconstructions