Ashwini SoodInternational Medical College, Malaysia
Title: Transcolumnar” a better Terminology than “Transverse” in Judet-Letournel Classification of Acetabular Fractures?
INTRODUCTION: Acetabular fractures are among the most complex and challenging injuries for orthopaedic surgeons. They require an understanding of the precise outline of the fracture by appropriate classification for decision making. For this purpose, the classification proposed by Judet and Letournel in 1963 remains the gold standard. However, the shortcomings have been highlighted. In this article the merits and demerits of the existing classifications are discussed and importantly a newer approach to classify acetabular fractures is proposed. METHODS: On the basis of anatomical features, a new classification is proposed. It places posterior column with posterior wall fractures to simple fractures instead of complex fractures in Judet and Letournel classification. More importantly the proposed new classification renames “transverse fracture” as “transcolumnar fracture” to better represent anatomical structure rather than morphology. RESULTS: The new classification shows greater consistency in criteria, and is based only on anatomy, unlike the Judet-Letournel classification which is based on anatomy, direction, and geometry. DISCUSSIONS: The classification described by Judet and Letournel is based on uniform criteria. It includes considerations of anatomy, direction and geometry, and may be difficulty to understand. The proposed classification is based on a single criterion: anatomy, decreasing the complexity. CONCLUSION: A new classification is proposed, based only on anatomy of the acetubular columns and walls. It is likely to make acetabular fractures easier to understand for orthopedic surgeons. make acetabular fractures easier to understand for orthopedic surgeons.
SOOD ASHWINI, Assoc. Professor at International Medical College, Malaysia