Classifications in Brief: Letournel Classification for Acetabular Fractures

Alton, Timothy B.; Gee, Albert O.

doi:10.1007/s11999-013-3375-y

Cited by 56 publications

(30 citation statements)

References 21 publications

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“…Details of the P + A injury were recorded, including fracture type according to the Young and Burgess classification for pelvic fractures, and Letournel classification for acetabular fractures (Appendix S1). Pelvic fractures were classified into lateral compression (LC) type 1 to 3, anterior posterior compression (APC) type 1 to 3 and vertical shear (VS).…”

Section: Methodsmentioning

confidence: 99%

Incidence and immediate management of genitourinary injuries in pelvic and acetabular trauma: a 10‐year retrospective study

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Incidence and immediate management of genitourinary injuries in pelvic and acetabular trauma: a 10‐year retrospective study

et al. 2018

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“…Several systems are available for the classification of acetabular fractures (Arbeitsgemeinschaft für Osteosynthesefragen [AO], Harris, etc.) 11 , 23 , but the most common is the Letournel (or Judet-Letournel) system 1 , 24 , 25 . This system is difficult to understand and to learn but remains the only widely accepted system to guide the surgical approach for acetabular fractures 25 .…”

Section: Discussionmentioning

confidence: 99%

“… 11 , 23 , but the most common is the Letournel (or Judet-Letournel) system 1 , 24 , 25 . This system is difficult to understand and to learn but remains the only widely accepted system to guide the surgical approach for acetabular fractures 25 . Several studies have shown low accuracy in association with the use of the Letournel system 26 .…”

Section: Discussionmentioning

confidence: 99%

A New, Easy, Fast, and Reliable Method to Correctly Classify Acetabular Fractures According to the Letournel System

Riouallon

Sebaaly

Upex

et al. 2018

JBJS OA

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Background:Accurate classification of acetabular fractures remains difficult. To aid in the classification of acetabular fractures and to aid in teaching, our department developed a diagnostic algorithm that involves the use of 1 standardized 3-dimensional reconstruction of a computed tomography (CT) scan (an exopelvic view without the femoral head) with 8 anatomical landmarks. The algorithm was integrated into a smartphone application (app). The main objective of this study was to test the efficacy of this algorithm and smartphone app.Methods:Fourteen reviewers (3 experts, 3 fellows, 3 residents, and 5 novice reviewers) evaluated a set of 35 CT scans of acetabular fractures in 2 phases. During the first phase, the scans (including axial 2-dimensional views and 3-dimensional (3D) multiplanar reconstruction views) were assessed by each reviewer twice, with an interval of 4 weeks between the readings to decrease recall bias. During that phase, the reviewers were provided with a diagram of the Letournel classification system with no guidelines for interpretation. During the second phase, performed 4 weeks after the first phase, 1 standardized 3D reconstruction (an exopelvic view without the femoral head) was reviewed twice, with an interval of 4 weeks between the readings. During that phase, the reviewers used the smartphone app. The primary outcome was the accuracy of classification. Interobserver reliability, reading time, and time needed for accurate classification were noted.Results:The accuracy of fracture classification was 64.5% when the standard method of analysis was used and 83.4% when the app was used (p < 0.001). Improvement was noted in all groups, with the expert group showing the least improvement (88.6% to 97.2%, p = 0.04) and the novice group showing the most improvement (42.0% to 75.5%, p < 0.001). Furthermore, use of the app greatly increased the accuracy of classification of complex fractures. The average reading time was 71.8 minutes when the standard method was used and 37.4 minutes when the app was used. The interobserver reliability improved in all groups to an excellent reliability (interclass correlation coefficient [ICC] > 0.79).Conclusions:The Letournel classification system is difficult to understand and to learn but remains the only system guiding the surgical strategy for acetabular fractures. The impact of diagnostic algorithms is debatable. The most important finding of the present study is the high accuracy for inexperienced groups when the app was used. Another important finding is the high reliability of this method for the diagnosis of complex acetabular fractures.

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Section: Discussionmentioning

confidence: 99%

“…Planning of the treatment for acetabular fracture and choice of surgical approach frequently depends on the pattern of displacement and the type of the fracture [ 13 , 24 , 25 ]. Computed tomographic (CT) evaluations help inexperienced surgeons to make correct classifications [ 20 , 24 ]. Kinok et al have highlighted that the correct definition of the fracture type, appropriate surgical selection, understanding acetabular anatomy, good fracture reduction, and surgical experience were important for good long-term outcomes in the surgical treatment of the displaced acetabulum [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Learning Curve for Surgical Treatment of Acetabular Fractures: A Retrospective Clinical Study of a Practical and Theoretical Training Course

et al. 2017

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BackgroundSurgical treatment of acetabular fracture and the anatomic reconstruction of the hip joint are difficult to achieve due to the complex pelvic anatomy, and surgical training requires a prolonged and steep learning curve. The aim of this study was to evaluate the effects of an applied training course, including cadaveric dissection, for the surgical treatment of acetabular fractures.Material/MethodsThis retrospective study included 35 patients who underwent surgical treatment for acetabulum fractures between 2012–2016. Patients were divided into three groups during two training courses, for the first two years and second two years. The surgical treatment was performed through single or combined standard approaches, according to the fracture pattern. The radiological outcome was evaluated using Matta’s criteria to grade postoperative reduction and final radiological outcome and the restoration of the hip joint center (HJC). The clinical outcome was evaluated using the modified the Merle d’Aubigné-Postel (DAP) hip score.ResultsBoth post-course groups had statistically better functional and radiological outcomes compared with the pre-course group. Depending on the learning curve, the mean duration of surgery decreased from 153 minutes to 82.3 minutes. Although there was no statistical difference between groups in the vertical shift of the HJC, there was a statistically significant in the amount of horizontal shift of the HJC in the second two years of training, compared with the other groups.ConclusionsFunctional and radiological outcome of surgical treatment of acetabular fracture may be improved with increased training, depending on the learning curve.

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Classifications in Brief: Letournel Classification for Acetabular Fractures

Cited by 56 publications

References 21 publications

Incidence and immediate management of genitourinary injuries in pelvic and acetabular trauma: a 10‐year retrospective study

Incidence and immediate management of genitourinary injuries in pelvic and acetabular trauma: a 10‐year retrospective study

A New, Easy, Fast, and Reliable Method to Correctly Classify Acetabular Fractures According to the Letournel System

Learning Curve for Surgical Treatment of Acetabular Fractures: A Retrospective Clinical Study of a Practical and Theoretical Training Course

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