Acetabular Fracture Radiology: Xrays, CT scan & 3D printing

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.

1. Radiology of Acetabular Fractures Dr Vaibhav Bagaria Director - Orthopedics Sir HN Reliance Foundation Hospital President - SICOT India Mumbai, India

2. Acetabular # Radiology X-rays and Special View Landmarks Fracture patterns CT Scan 3DGraphy: 3D Printed models

3. Anatomy

4. Modality

5. Xrays AP Judet’s View Inlet and Outlet View Intraop/ EUA imaging

6. Six Golden Line 1 - Iliopectineal Line 2. Ilioischial line 3. Tear drop 4. Radiographic roof 5. Anterior Rim 6. Posterior Rim

7. Obturator View

8. Obturator view

9. Illiac Oblique

10. Illiac View

11. Roof Arc Angle

12. Roof Arc angle

13. Roof Arc Angle The angle formed between a vertical tangent through femoral head and a vertical line though the fracture. It helps determine the fracture pattern stability if the fracture line exits outside the weight bearing dome of the acetabulum it is considered a stable fracture.

14. Gull Sign represents impaction of superomedial roof seen on iliac oblique view pathognomic for posterior wall fractures

15. Spur Sign Represents most caudal part of intact ilium due to medialization of articular components Seen on obturator view Pathogonomic of ABC #

16. Classification

17. CT SCAN Look at the orientation of fracture line Look at position or quadrant of fracture look at the level of the fracture

18. Orientation Oblique Horizontal Verticaal Combination

19. Oblique # Line:ant wall ,post wall Horizontal # Line: Anterior, Posterior or both column Vertical: Transverse; T shaped Horizontal & Oblique: Posterior Wall + Column

20. Location

21. Level

22. 3D reconstruction

23. Posterior wall

24. Posterior wall

25. Posterior Column

26. Posterior Column

27. Posterior Column

28. Anterior Wall

29. Anterior Wall

30. Anterior Wall

31. Anterior Wall

32. Transverse Fractures

33. ABC - Assoc Both Column

34. ABC

35. Transverse + Post wall

36. T Type

37. Ant Column with Post Hemitransverse

38. Post Column + Wall

39. 3Dgraph

40. 3D Graphs

41. 3Dgraphs

42. Templating on 3Dgraph

43. 3D printed Jigs- POST Patient Optimised Surgical tools

44. EUA

45. Algorithim