Anterior column

Anterior column fractures separate a segment of anterior acetabulum from the rest of the innominate bone. The fracture starts from the middle of the ischiopubic ramus below, and then passes through the anterior acetabulum.

The proximal extension of this fracture passes variably through the innominate bone, at different levels above the acetabulum, as far upwards as the middle third of the iliac crest.

Anterior column fractures are described by the level of their proximal extent. They may also be segmental.

These fractures may also be associated with:

• Fracture along the pelvic brim
• Medialization of the quadrilateral surface
• Marginal impaction
• Intraarticular fracture fragments
• Anterior and medial displacement

Further details on anterior column fractures are provided in section Characteristics of elemental fracture types.

A summary of diagnosing the fracture classification based on x-ray and CT images is presented in section Patient assessment.

The section Radiology of the intact acetabulum provides explanation of the radiologic landmarks.

The section Characteristics of elemental fracture types provides further information on the radiology of anterior column fractures.

X-ray image of anterior column fracture, courtesy of TA Ferguson