Acetabular Fractures Revisited: Part I, Redefinition of the Letournel Anterior Column
John H. Harris, Jr.1,2,
Jody S. Lee1,3,
Kevin J. Coupe4 and
Thea Trotscher4
1 Department of Radiology, University of Texas-Houston Medical School, 6431
Fannin, Houston, TX 77030.
2 Present address: 200 Alta Vista Dr., Sedona, AZ 86351.
3 Present address: 2019 Red Magnolia Ct., Kingwood, TX 77339.
4 Department of Orthopaedic Surgery, University of Texas-Houston Medical School,
Houston, TX.
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Fig. 1. —Schematic representation shows mid acetabular CT scan. Line
a–a1 establishes anterior (AC) and posterior (PC) columns.
Anterior (AW) and posterior (PW) walls lie lateral to line
b–b1.
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Fig. 2. —Schematic representation shows anterior (AC) and posterior
(PC) columns as defined by Letournel on outer (A) and inner (B) surface of
innominate bone.
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Fig. 3. —Drawing shows medial (inner) surface of right innominate bone
with arcuate line (arrowheads), iliopectineal eminence (curved
arrow), and pubic tubercle (straight arrow). (Reprinted from
[14])
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Fig. 4. —Axial CT scan shows column anatomy of iliac base. Image of
pelvic skeleton was superimposed on CT scout view of patient's pelvis from
which axial images were obtained. Left midhemi acetabular axial CT scan is
shown for reference purposes. Axial CT supraacetabular images a–d show
axial CT anatomy of iliac base. Anterior column is indicated by gray arrow;
iliopectineal line, by white arrow; and posterior column, by black arrow. W =
wall.
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Fig. 5. —Schematic representation shows ossification centers of
innominate bone of 8-year-old child. That portion of triradiate cartilage
separating pubic bone from ilium and ischium (arrowheads) identifies
division between anterior and posterior columns. In essence, pubic bone,
including its iliopectineal eminence (arrow), constitutes anterior
column. (Reprinted from
[14])
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Fig. 6. —Anteroposterior radiograph of right hip of patient with type
IIA acetabular fracture (open arrow) shows iliopectineal
(arrowheads) and ilioischial (solid arrows) lines.
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Fig. 7A. —Anatomically defined anterior column of acetabulum.
Arrowheads indicate anterior inferior iliac spine; curved arrows,
iliopectineal eminence; and straight arrows, pubic tubercle. Schematic
representation shows anatomically redefined anterior (dotted area)
and Letournel-defined posterior (striped area) column in internal
projection.
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Fig. 7B. —Anatomically defined anterior column of acetabulum.
Arrowheads indicate anterior inferior iliac spine; curved arrows,
iliopectineal eminence; and straight arrows, pubic tubercle. Schematic
representation shows anatomically redefined anterior (dotted area)
and Letournel-defined posterior (striped area) columns in obturator
oblique projection.
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Fig. 7C. —Anatomically defined anterior column of acetabulum.
Arrowheads indicate anterior inferior iliac spine; curved arrows,
iliopectineal eminence; and straight arrows, pubic tubercle. Schematic
representation shows anatomically redefined anterior (dotted area)
and Letournel-defined posterior (striped area) columns in lateral
projection.
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Copyright © 2004 by the American Roentgen Ray Society.
