Inominate Bone has two coulmns -anterior and have posterior columns. The acetabulum is contained between these two columns, as they meet in the shape of an inverted Y in the innominate bone.
The anterior column, which consists of the iliac wing and pelvic brim, extends to the pubic symphysis and contains the anterior one half of the acetabular articular surface.
The posterior column consists of the greater and lesser sciatic notches, the retroacetabular surface, and the majority of the quadrilateral surface.
Similarly, the posterior column contains the posterior one half of the acetabular articular surface.
The goal of surgical treatment of fractures of acetabulum is an accurate reconstruction of the articular surface.
The internal iliac fossa, the quadrilateral surface, and the retroacetabular surface describe large cortical surface of the innominate bone.
The pelvic brim marks the junction of the intenral iliac fossa and quadrilateral surface.
The sciatic notch marks the junction of the quadrilateral surface and the retroacetabular surface.
Apart from plain radiographs and special views of xrays computerized tomography (CT) can also be used to visualize acetabular fractures.
In the majority of cases, the fracture pattern can be identified and thus classified from plain films alone.
Plain films are usually best for assessing the congruence between the femoral head and the roof of the acetabulum.
Plain film radiography has been the standard by which articular displacement has been measured, both before and after surgery.
In the emerging age of digital radiography, however, the CT image is fast becoming a more reliable method of articular assessment.
CT is better suited for evaluating certain fracture characteristic including
- Marginal impaction
- Rotation of major fragments
- Coronal fracture lines
- Incarcerated osteochondral fragments.
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