Classifications in brief: Letournel classification for acetabular fractures.

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 described, divided into elementary and associated patterns. In 1980, using radiographic and surgical data from 647 acetabular fractures, of which 582 had undergone surgical fixation, Letournel [11] confirmed and updated his original description [8]. He divided acetabular fractures into 10 subtypes, five elementary patterns and five associated patterns (including more than one elementary pattern). Elementary patterns included posterior wall fractures, posterior column, anterior column, anterior wall, and transverse fracture patterns. Associated patterns include T-shaped, posterior column and posterior wall, transverse and posterior wall, anterior and hemitransverse, and fractures of both columns [11] (Fig. 1).