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Clinical Orthopaedics and Related Research®

, Volume 472, Issue 1, pp 35–38 | Cite as

Classifications in Brief: Letournel Classification for Acetabular Fractures

  • Timothy B. AltonEmail author
  • Albert O. Gee
In Brief

History

In December 1961, Letournel [10] published his original series on acetabular fracture classification and operative management. Before that time, acetabular fractures were classified as those associated with posterior hip dislocation and those associated with central hip dislocation. Many were treated without surgery, resulting in poor articular congruity of the hip. Citing an increasing incidence of these injuries with the increasing number of automobiles on the road and “disappointment with the closed treatment of these fractures, we [Judet et al.] decided to try open reduction” [8]. Their series included 173 patients, 129 of whom were treated surgically. Pelvic radiographs were correlated with surgical findings. The anterior and posterior columns of the acetabulum were defined based on the radiographic projections of normal and fractured acetabula on three views: AP pelvic film and internal and external 45° obliques (Judet views). Seven acetabular fracture patterns were...

Keywords

Fracture Pattern Acetabular Fracture Posterior Column Intraobserver Reliability Posttraumatic Arthritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Beaulé PE, Dorey FJ, Matta JM. Letournel classification for acetabular fractures. Assessment of interobserver and intraobserver reliability. J Bone Joint Surg Am. 2003;85:1704–1709.PubMedGoogle Scholar
  2. 2.
    Briffa N, Pearce R, Hill AM, Bircher M. Outcomes of acetabular fracture fixation with ten years’ follow-up. J Bone Joint Surg Br. 2011;93:229–236.PubMedCrossRefGoogle Scholar
  3. 3.
    Calkins MS, Zych G, Latta L, Borja FJ, Mnaymneh W. Computed tomography evaluation of stability in posterior fracture dislocation of the hip. Clin Orthop Relat Res. 1988;227:152–163.PubMedGoogle Scholar
  4. 4.
    Garrett J, Halvorson J, Carroll E, Webb LX. Value of 3-D CT in classifying acetabular fractures during orthopedic residency training. Orthopedics. 2012;35:e615–620.PubMedCrossRefGoogle Scholar
  5. 5.
    Grimshaw CS, Moed BR. Outcomes of posterior wall fractures of the acetabulum treated nonoperatively after diagnostic screening with dynamic stress examination under anesthesia. J Bone Joint Surg Am. 2010;92:2792–2800.PubMedCrossRefGoogle Scholar
  6. 6.
    Harley JD, Mack LA, Winquist RA. CT of acetabular fractures: comparison with conventional radiography. AJR Am J Roentgenol. 1982;138:413–417.PubMedCrossRefGoogle Scholar
  7. 7.
    Hüfner T, Pohlemann T, Gansslen A, Assassi P, Prokop M, Tscherne H. [The value of CT in classification and decision making in acetabulum fractures. A systematic analysis] [in German]. Der Unfallchirurg. 1999;102:124–131.PubMedCrossRefGoogle Scholar
  8. 8.
    Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. preliminary report. J Bone Joint Surg Am. 1964;46:1615–1646.PubMedGoogle Scholar
  9. 9.
    Keith JE Jr, Brashear HR Jr, Guilford WB. Stability of posterior fracture-dislocations of the hip. Quantitative assessment using computed tomography. J Bone Joint Surg Am. 1988;70:711–714.PubMedGoogle Scholar
  10. 10.
    Letournel E. [Fractures of the cotyloid cavity, study of a series of 75 cases] [in French]. J Chronic Dis. 1961;82:47–87.PubMedGoogle Scholar
  11. 11.
    Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res. 1980;151:81–106.PubMedGoogle Scholar
  12. 12.
    Lichte P, Sellei RM, Kobbe P, Dombroski DG, Gansslen A, Pape HC. Predictors of poor outcome after both column acetabular fractures: a 30-year retrospective cohort study. Patient Saf Surg. 2013;7:9.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Moed BR, Ajibade DA, Israel H. Computed tomography as a predictor of hip stability status in posterior wall fractures of the acetabulum. J Orthop Trauma. 2009;23:7–15.PubMedCrossRefGoogle Scholar
  14. 14.
    Murphy D, Kaliszer M, Rice J, McElwain JP. Outcome after acetabular fracture. Prognostic factors and their inter-relationships. Injury. 2003;34:512–517.PubMedCrossRefGoogle Scholar
  15. 15.
    Ohashi K, El-Khoury GY, Abu-Zahra KW, Berbaum KS. Interobserver agreement for Letournel acetabular fracture classification with multidetector CT: are standard Judet radiographs necessary? Radiology. 2006;241:386–391.PubMedCrossRefGoogle Scholar
  16. 16.
    Olson SA, Bay BK, Pollak AN, Sharkey NA, Lee T. The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint. J Orthop Trauma. 1996;10:395–402.PubMedCrossRefGoogle Scholar
  17. 17.
    Porter SE, Russell GV, Dews RC, Qin Z, Woodall J Jr, Graves ML. Complications of acetabular fracture surgery in morbidly obese patients. J Orthop Trauma. 2008;22:589–594.PubMedCrossRefGoogle Scholar
  18. 18.
    Prevezas N, Antypas G, Louverdis D, Konstas A, Papasotiriou A, Sbonias G. Proposed guidelines for increasing the reliability and validity of Letournel classification system. Injury. 2009;40:1098–1103.PubMedCrossRefGoogle Scholar
  19. 19.
    Rommens PM, Ingelfinger P, Nowak TE, Kuhn S, Hessmann MH. Traumatic damage to the cartilage influences outcome of anatomically reduced acetabular fractures: a medium-term retrospective analysis. Injury. 2011;42:1043–1048.PubMedCrossRefGoogle Scholar
  20. 20.
    Shirkhoda A, Brashear HR, Staab EV. Computed tomography of acetabular fractures. Radiology. 1980;134:683–688.PubMedGoogle Scholar
  21. 21.
    Tornetta P 3rd. Non-operative management of acetabular fractures. The use of dynamic stress views. J Bone Joint Surg Br. 1999;81:67–70.PubMedCrossRefGoogle Scholar
  22. 22.
    Vailas JC, Hurwitz S, Wiesel SW. Posterior acetabular fracture-dislocations: fragment size, joint capsule, and stability. J Trauma. 1989;29:1494–1496.PubMedCrossRefGoogle Scholar
  23. 23.
    Visutipol B, Chobtangsin P, Ketmalasiri B, Pattarabanjird N, Varodompun N. Evaluation of Letournel and Judet classification of acetabular fracture with plain radiographs and three-dimensional computerized tomographic scan. J Orthop Surg (Hong Kong). 2000;8:33–37.PubMedGoogle Scholar
  24. 24.
    Zha GC, Sun JY, Dong SJ. Predictors of clinical outcomes after surgical treatment of displaced acetabular fractures in the elderly. J Orthop Res. 2013;31:588–595.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  1. 1.Department of Orthopaedics and Sports MedicineUniversity of WashingtonSeattleUSA

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