Acetabular Fracture Radiology: Xrays, CT scan & 3D printingVaibhav Bagaria
The talk details how to assess various types of acetabular fracture. Combination of X-rays, CT Scan and 3D reconstruction and 3D printing also known as 3DGraphy. Basic 8 patterns and importance of various radiological parameter are explained.
about basics of cartilage imaging.
how does normal cartilage look , how does diseased cartilage look.
what are advanced techniques in cartilage imaging
MRI imaging of knee joint -- from radiological anatomy to pathology. inspired from my dear professor Mamdouh Mahfouz, professor of radio diagnosis - Cairo university.
Acetabular Fracture Radiology: Xrays, CT scan & 3D printingVaibhav Bagaria
The talk details how to assess various types of acetabular fracture. Combination of X-rays, CT Scan and 3D reconstruction and 3D printing also known as 3DGraphy. Basic 8 patterns and importance of various radiological parameter are explained.
about basics of cartilage imaging.
how does normal cartilage look , how does diseased cartilage look.
what are advanced techniques in cartilage imaging
MRI imaging of knee joint -- from radiological anatomy to pathology. inspired from my dear professor Mamdouh Mahfouz, professor of radio diagnosis - Cairo university.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
3. From the lateral aspect of the
pelvis, the innominate osseous
structural support of the
acetabulum may be
conceptualized as a two-
columned construct forming an
inverted Y:
1. Anterior column (iliopubic
component): extends from iliac
crest to symphysis pubis and
includes the anterior wall of the
acetabulum.
2. Posterior column (ilioischial
component): extends from
superior gluteal notch to ischial
tuberosity and includes the
posterior wall of the
acetabulum.
4. The anterior and posterior walls
extend from each respective
column and form the cup of the
acetabulum.
The anterior and posterior
columns connect to the axial
skeleton through a strut of bone
called the sciatic buttress.
5.
6. When looking at the acetabulum en face, the
anterior and posterior columns have the
appearance of the Greek letter lambda (λ).
The anterior column represents the longer,
larger portion, which extends superiorly from
the superior pubic ramus into the iliac wing.
The posterior column extends superiorly from
the ischiopubic ramus as the ischium toward
the ilium.
The anterior and posterior columns of bone
unite to support the acetabulum.
In turn, the sciatic buttress extends posteriorly
from the anterior and posterior columns to
become the articular surface of the sacroiliac
joint, which attaches the columns to the axial
skeleton.
The anterior and posterior walls, which extend
from the columns and support the hip joint, are
well seen on an axial CT.
7. The anterior and posterior walls, which extend
from the columns and support the hip joint, are
well seen on an axial CT.
Axial section
through
acetabulum
shows anterior
(arrowhead)
and posterior
(arrow) walls.
8. Acetabular dome: The superior weight-bearing
portion of the acetabulum at the junction of
the anterior and posterior columns, including
contributions from each.
11. Mechanism of injury
Like pelvis fractures, these injuries are
mainly caused by high-energy trauma
secondary to a motor vehicle, motorcycle
accident, or fall from a height.
12. Mechanism of injury
The fracture pattern depends on
Position of femoral head at the time of injury,
Magnitude of force, &
Age of patient.
13. Mechanism of injury
Direct impact to greater trochanter with:
Hip in neutral: transverse acetabular fracture
An abducted hip: low transverse fracture,
An adducted hip: high transverse fracture.
Hip externally rotated and abducted:
anterior column injury.
Hip internally rotated: posterior column
injury.
14. Mechanism of injury
With indirect trauma, (e.g., a ‘dashboard’
injury to the flexed knee):
As the degree of hip flexion increases, the posterior
wall is fractured in an increasingly inferior position.
Similarly, as the degree of hip flexion decreases,
the superior portion of posterior wall is more likely
to be involved.
15. Clinical evaluation
Trauma evaluation: with attention to ABCD, depending on the
mechanism of injury.
Patient factors (age, degree of trauma, presence of associated
injuries, & general medical condition) affect treatment
decisions as well as prognosis.
Neurovascular assessment:
Sciatic nerve injury may be present in up to 40% of posterior column
disruptions.
Femoral nerve involvement with anterior column injury is rare,
although compromise of the femoral artery by a fractured anterior
column has been described.
Presence of associated ipsilateral injuries must be ruled out,
with particular attention to the ipsilateral knee in which
posterior instability and patellar fractures are common.
Soft tissue injuries (e.g., abrasions, contusions, subcutaneous
hemorrhage) may provide insight into the mechanism of injury.
18. Anatomic landmarks in AP
view
Iliopectineal line (limit of anterior
column),
Ilioischial line (limit of posterior
column),
Anterior lip,
Posterior lip,
Line depicting the superior
weight-bearing surface,
terminating as the medial
teardrop.
22. Iliac oblique radiograph
(45-degree external rotation view)
Taken by rotating the
patient into 45° of external
rotation by elevating the
uninjured side on a wedge.
This best demonstrates:
Posterior column (ilioischial
line),
Iliac wing,
Anterior wall of acetabulum.
25. Obturator oblique radiograph
(45-degree internal rotation view)
This is best for evaluating
the anterior column and
posterior wall of the
acetabulum.
Taken by elevating the
affected hip 45° to the
horizontal by means of a
wedge and directing the
beam through the hip joint
with a 15° upward tilt.
34. Radiographic evaluation
CT scan
Provides additional information regarding size
& position of column fractures, impacted
fractures of acetabular wall, retained bone
fragments in the joint, degree of comminution,
and sacroiliac joint disruption.
Two- and three-dimensional CT scans are
useful in evaluating intra-articular fragments as
well as specific morphologic characteristics of
any given fracture pattern.
35. Radiographic evaluation
CT scan
Before a 3-dimensional CT
scan is ordered, the fracture
patterns should be drawn on a
3-dimensional model of the
pelvis to compare the 3-
dimensional reconstructions.
Three-dimensional
reconstruction allows for
digital subtraction of femoral
head, with full delineation of
the acetabular surface.
39. Accurate classification of acetabular fractures is
important for determining the proper surgical
treatment.
Although radiographic examination provides
essential information for acetabular classification,
CT, including multiplanar reconstruction, is
helpful in the visualization of complex fractures.
Classification
40. Because of the complex acetabular anatomy, various
classification schemes have been suggested, but the
Judet-Letournel classification system remains the
most widely accepted.
This classification system subdivides acetabular
fractures into
Elementary Fracture Types (posterior wall, posterior
column, anterior wall, anterior column and transverse)
Associated Fracture Types (T-shaped, posterior column and
wall, anterior wall or column with posterior hemitransverse,
and both column).
Classification
(Judet-Letournel)
49. The isolated posterior wall
fracture is one of the most
common types of acetabular
fracture, with a prevalence of
27%.
The ischium is disrupted.
The fracture line originates
at the greater sciatic notch,
travels across the
retroacetabular surface, exits
at the obturator foramen.
The ischiopubic ramus is
fractured.
Posterior wall fractures
50. An isolated posterior wall fracture does not
have a complete transverse acetabular
component.
Therefore, the iliopectineal line is not disrupted,
which excludes classification of the transverse
with posterior wall fracture.
However, disruption of the ilioischial line may or
may not be present as an extension of the
comminuted posterior wall component.
Oblique (Judet) radiographs and CT are helpful
in showing the isolated posterior wall fracture.
Posterior column fractures
51. 18-year-old man with isolated posterior wall acetabular fracture
AP pelvic radiograph
Bilateral oblique
pelvic radiographs
Axial CT
images
52. 18-year-old man with isolated posterior wall acetabular fracture
Parasagittal
reconstruction CT
image
53. Posterior wall and posterior
column fractures can be
distinguished easily.
In a posterior column fracture, the
ilioischial line is interrupted.
In a posterior wall fracture, only
the retroacetabular surface is
disrupted.
Posterior column fractures
55. Anterior wall and anterior column
fractures can be distinguished by
the additional break in the
ischiopubic segment of the pelvis
present in the anterior column
fracture.
Anterior wall and anterior
column fractures
58. A transverse acetabular fracture
involves a fracture line that goes
through both columns of the
acetabulum, but a portion of the
dome of the acetabulum remains
attached to the constant
fragment of the iliac wing.
Transverse Fracture
60. Types (depending on the orientation of the fracture line relative to the
dome or tectum of the acetabulum):
1. Transtectal: through the acetabular dome.
2. Juxtatectal: through the junction of acetabular dome &
fossa acetabuli.
3. Infratectal: through the fossa acetabuli.
Transtectal fractures are less forgiving and must be
reduced anatomically, whereas infratectal fractures, if
low enough, can be treated without surgery,
depending on the pattern.
The femoral head follows the inferior ischiopubic
fragment and may dislocate centrally.
Transverse Fracture
62. 23-year-old woman with transverse acetabular fracture
AP pelvic radiograph
Bilateral oblique pelvic
radiographs
Axial CT scan
surface-
rendering
3D CT
viewed
laterally,
with right
hemipelvis
and femur
removed
63. Transverse fractures are sagittal plane
fractures whereas both column
fracturesare coronal plane fractures.
Transverse Fracture
69. Transverse fracture of any type
+
Vertical fr through the isciopubic fragment
The vertical component is best
seen on the obturator oblique
view.
T-shaped fracture
70. The T-shaped fracture is
similar to a both-column fracture
in that it disrupts the obturator
ring.
Another similarity is disruption of
both the iliopectineal and
ilioischial lines.
However, the superior extension
of the fracture does not involve
the iliac wing, which allows
differentiation from the both-
column fracture.
T-shaped fracture
71. One area of potential confusion with the Tshaped
fracture is in regard to the transverse component.
The transverse fracture line is not actually in the
anatomic transverse plane, but rather it is
transverse relative to the acetabulum.
Because the cup shape of the acetabulum is
normally tilted inferiorly and anteriorly, the
transverse fracture plane assumes a similar
orientation.
Therefore, on radiographs, the fracture lines that
disrupt the iliopectineal and ilioischial lines course
superiorly and medially in an oblique plane from
the acetabulum.
This is best appreciated by looking at the
acetabulum en face.
On CT, this transverse fracture component is
seen as a sagittally oriented fracture coursing
medially and superiorly from the acetabulum.
T-shaped fracture
72. T-type fractures differ from transverse fractures by the additional
fracture line that runs through the quadrilateral surface.
As a result, the anterior column and posterior column are
separated by fracture lines.
This becomes important when choosing a surgical approach to
the acetabulum.
In a pure transverse fracture, the anterior and posterior columns
may be reduced through a single approach.
Once the anterior column has been reduced, the posterior
column will follow the reduction and can be palpated indirectly.
T-shaped fracture
73. Radiograph of
a T-type
fracture.
Note the
undisplaced
fracture in the
ischiopubic
ramus.
This break in the
obturator ring
correlates with
an additional
fracture line in
the
quadrilateral
plate.
74. In a T-type fracture, the 2 columns must
be reduced independently.
This becomes extremely important when
choosing a surgical approach; therefore,
it is important to recognize the subtle
difference between transverse and T-type
fractures when they are not significantly
displaced.
T-shaped fracture
76. Note in the T-type fracture the anterior
and posterior columns are disassociated
77. 40-year-old man with T-shaped acetabular fracture
AP pelvic radiograph
Bilateral oblique pelvic
radiographs
Axial CT scan
Surface-rendering 3D CT viewed laterally, with right
hemipelvis and femur removed
78. Transverse fracture
+
Comminuted posterior wall
fracture (usually displaced)
The iliopectineal and
ilioischial lines are
disrupted.
The obturator oblique view
best demonstrates the
position of the transverse
component as well as the
Transverse and
posterior wall fracture
80. 20-year-old man showing transverse with posterior wall acetabular
fracture
AP pelvic radiograph
Bilateral oblique pelvic
radiographs
axial
CT
scan
surface-
rendering
3D CT
viewed
laterally,
with right
hemipelvis
and femur
removed
82. Both columns are separated from
each other and from the axial
skeleton, resulting in a ‘floating’
acetabulum
This is the most complex type of
acetabular fracture.
A both columns fracture can be
considered a ‘high’ T-shaped
fracture where both columns have
been separated from the sciatic
buttress.
Both-column fracture
(formerly called ‘central acetabular fracture’)
83. The "spur-sign," best seen on the
obturator oblique view, is
pathognomonic for the both-column
fracture.
This sign represents posterior
displacement of the sciatic buttress
of the iliac wing fracture, which
essentially disconnects the roof of
the acetabulum from the axial
skeleton.
When this occurs, weight from the
torso and upper body can no
longer be supported by the
acetabulum.
Both-column fracture
(formerly called ‘central acetabular fracture’)
"Spur-sign" seen on the
obturator oblique view
84. On radiographs and CT, the
spur sign appears as a shard
of bone extending posteriorly
at the level of the superior
acetabulum.
Evaluation of sequential CT
images shows the fracture,
which separates the sciatic
buttress from the acetabular
roof.
Both-column fracture
(formerly called ‘central acetabular fracture’)
85. 35-year-old man with a both-column fracture
Oblique pelvic radiograph (A) and axial CT image (B) show
spur sign (arrow), which represents displacement of fracture
involving sciatic buttress (arrowheads).
Note that sciatic buttress (arrowheads, B) no longer connects
to weight-bearing portion of acetabulum.
A B
86. 45-year-old man with both-column acetabular fracture
AP pelvic radiograph
Bilateral oblique pelvic radiographs
Axial CT scan
sagittal
reconstruction
CT scan
87. 3-D CT scan of a both-column acetabular fracture; obturator3-D CT scan of a both-column acetabular fracture; obturator
oblique viewoblique view
88. 3-D CT scan of a both-column acetabular fracture; iliac oblique view3-D CT scan of a both-column acetabular fracture; iliac oblique view
96. Subsequent to the pioneering work of Judet and Letournel,
their classification was then used as the basis for formulating
an alphanumeric computerized format and the Comprehensive
Classification of Fractures of the Acetabulum was developed.
This effort was spearheaded by SICOT International
Documentation and Evaluation Committee and the AO/ASIF
Foundation under the leadership of Maurice E. Muller.
Each fracture is classified according to morphological
characteristics, and subdivided into types, groups, and
subgroups.
The system is especially beneficial for research database
applications.
Classification
(The Comprehensive Classification of Fractures of the
Acetabulum)
98. References
Durkee NJ, Jacobson J, Jamadar D, Karunakar MA,
Morag Y, Hayes C: Classification of Common
Acetabular Fractures: Radiographic and CT
Appearances. AJR 2006; 187: 915-925
Gänsslen A, Oestern HJ: Azetabulumfrakturen. Chirurg
2011; 82:1133–1150
Jimenez ML: Classification of Acetabular Fractures.
Medscape.com
Pagenkopf E, Grose A, Partal G, Helfet DL: Acetabular
Fractures in the Elderly: Treatment Recommendations.
HSSJ (2006) 2: 161–171
Editor's Notes
Röntgendiagnostik in konventioneller Technik: Nach der Beckenübersichtsaufnahme weitere Differenzierung der dorsalen Beckenringläsion durch die Inlet- und Outletaufnahmen, Differenzierung der Acetabulumfraktur durch die Obturator- und Alaaufnahmen
Iliopectineal line (1) Ilioischial line (2) Teardrop (the medial portion of the teardrop represents the quadrilateral surface and the lateral portion represents the medial aspect aspect of the acetabular floor) (3) Dome (4) Anterior wall (5) Posterior wall (6)
Landmarks on the obturator oblique view
18-year-old man with isolated posterior wall acetabular fracture. A–F, AP pelvic radiograph ( A ), bilateral oblique pelvic radiographs ( B, C ), axial CT images ( D, E ), and parasagittal reconstruction CT image ( F ) show displaced fracture fragments ( curved arrows ) from isolated posterior wall fracture ( straight arrow, D ).
18-year-old man with isolated posterior wall acetabular fracture. A–F, AP pelvic radiograph ( A ), bilateral oblique pelvic radiographs ( B, C ), axial CT images ( D, E ), and parasagittal reconstruction CT image ( F ) show displaced fracture fragments ( curved arrows ) from isolated posterior wall fracture ( straight arrow, D ).
23-year-old woman with transverse acetabular fracture. A–E, AP pelvic radiograph ( A ), bilateral oblique pelvic radiographs ( B, C ), axial CT scan ( D ), and surface-rendering 3D CT scan viewed laterally ( E ), with right hemipelvis and femur removed, show fracture ( arrows ) orientation transverse to acetabulum, disrupting iliopectineal and ilioischial lines ( arrowheads ). Note characteristic sagittal – oblique fracture plane on CT scan ( D ).
40-year-old man with T-shaped acetabular fracture. A–E, AP pelvic radiograph ( A ), bilateral oblique pelvic radiographs ( B, C ), axial CT scan ( D ), and surface-rendering 3D CT scan viewed laterally ( E ), with right hemipelvis and femur removed, show obturator ring fractures ( arrowheads ) and transverse component ( arrows ) through acetabulum. Note characteristic oblique – sagittal orientation of transverse acetabular fracture component on CT scans that is transverse relative to acetabulum on radiographs.
20-year-old man showing transverse with posterior wall acetabular fracture. A–E, AP pelvic radiograph ( A ), bilateral oblique pelvic radiographs ( B, C ), axial CT scan ( D ), and surface-rendering 3D CT scan viewed laterally ( E ), with right hemipelvis and femur removed, show transverse fracture ( straight arrows ) disrupting iliopectineal and ilioischial lines ( arrowheads ) with displaced and comminuted posterior wall fracture fragment ( curved arrows ).
35-year-old man with both-column acetabular fracture and spur sign. A and B, Oblique pelvic radiograph ( A ) and axial CT image ( B ) show spur sign ( arrow ), which represents displacement of fracture involving sciatic buttress ( arrowheads ). Note that sciatic buttress ( arrowheads, B ) no longer connects to weight-bearing portion of acetabulum.
45-year-old man with both-column acetabular fracture. A–E, AP pelvic radiograph ( A) , bilateral oblique pelvic radiographs ( B, C ), axial CT scan ( D ), and sagittal reconstruction CT scan ( E ) show acetabular fracture ( straight arrows , A–C ), with break in obturator ring ( arrowheads , A–C ) and extension into iliac wing ( curved arrows ). Note coronal plane of fracture on CT and superior pubic ramus fractured at puboacetabular junction.