Judet letournel approach

Judet letournel approach. La voie ilio-inguinale a été introduite et développée initialement par Letournel au début des années 1960 []. 2106/00004623-196446080-00001. Apr 19, 2014 · Of note, our rate of using the posterior approach alone was similar to other studies (our study 82%, Matta 77% , Gansslen et al. The following lines, known as Letournel lines, are useful: iliopectineal line Judet-Letournel Type and a Coccygeal Fracture in a Severe Polytrauma Patient Jessica Fiolin a Ludwig Andre Powantia Pontoh a, b Ismail Hadisoebroto cDilogo aJakarta Knee, Shoulder and Orthopaedic Sports Center, Pondok Indah General Hospital, Jakarta, Indonesia; bDepartment of Orthopaedic and Traumatology, Faculty of Medicine Surgical management of acetabular fractures. The Judet family represents a unique history, since several orthopaedic procedures are known as “Judet’s technique”. Due to the Case Report: Two similar cases according to the classification of Judet-Letournel acetabulum fractures were chosen. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database Jun 13, 2016 · Complex fracture patterns often require exposure of both the anterior and posterior columns for adequate visualization and reduction. JUDET Preface to the French Edition It is a long time since we first attempted surgical treatment of fractures of the acetabulum accompanied by displacement, with the aim of restoring perfect articulation. e. Furthermore, the new APQ classification is more comprehensible and practical than the Judet-Letournel classification. R JUDET, J JUDET, E LETOURNEL. This report may provide clinicians with a better treatment option for this rare injury and promote an update of the Judet–Letournel classification. Case 2 illustrates the Extensile Judet. Johnson EE, Matta JM, Mast JW, Letournel E. After finishing secondary school in Saint Pierre, he obtained a scholarship to the French Institute in London Nov 18, 2014 · The Letournel-Judet system as being an anatomic classification, based on plain X-rays, cannot adequately serve as a prognostic factor for operative or non-operative management, especially nowadays that the Computed Tomography provides a detailed approach to such fractures. Some institutions will advise the Judet views are done as a full two view oblique pelvis (see figure 1 and 2). Until now, diverse surgical approaches have been used for the reduction of acetabular fractures and they are categorized into anterior, posterior, extensile, and combined approaches. , in 1964. I felt this was necessary for several reasons: new imaging technologies such as CT scanning and 3-D reconstructions are now used routinely, the in­ dications for employing improved approaches are clearer, and reconstructions are facilitated by new internal fixation devices. a fairly limited approach to the shoulder, allowing little anterior exposure. They suggested an algorithm for evaluating pelvic radiographs based first on Sep 22, 2020 · Judet R, Judet J, Letournel E. found inexperienced orthopaedic surgeons accurately applied Letournel’s classification for acetabular fractures in only 11% of cases. 11 demonstrated that there is low concordance in the Judet and Letournel classification among inexperienced evaluators, such as residents. A modified pararectus approach was used in our case, which could facilitate exposure, reduction, and osteosynthesis for atypical acetabular fracture with less invasiveness. It classifies fracture based on oblique pelvic view on plain radiographs. ) 11,23, but the most common is the Letournel (or Judet-Letournel) system 1,24,25. 22. posterior articular segments. However, the shortcomings have been highlighted by many and hence, a newer approach to classify acetabular fracture for better management strategies is of utmost Jul 31, 2019 · The fracture classification system developed by Judet and Letournel is the most widely accepted system; it differentiates fractures into ten types, five elementary fractures and five associated fractures based on observations from plain radiographs. J Bone Joint Surg Am. Thorough assessment of the acetabulum (in the absence of CT) should include oblique internal and external pelvis views (Judet views). proximal humerus fracture-dislocations (posterior) scapula fractures. Instr Course Lect 1986;35:382-97. Modified Merle d’Aubigne and Postel criteria were used for functional assessment. Nov 9, 2013 · Hüfner et al. Aug 19, 2019 · Thirty-seven acetabular fractures in 35 patients treated with an anterior approach were evaluated retrospectively. Case 1 demonstrates the Modified Judet approach. The most common surgical approach to treating an acetabular fracture is the anterior approach. The associated fracture patterns are composed of a combination of at least two of the elementary fracture patterns. In 2009, Prevezas et al. 1 This approach provides access to most of the anterior acetabulum, iliac surface, pelvic brim and anterior sacroiliac joint. PMID: 14239854 No abstract available. This study highlights the role of 3- … Aug 25, 2023 · Judet and Letournel have classified acetabular fractures into 10 subtypes, addressing each fracture pattern and identifying the appropriate surgical approach for each of them. This classification is associated with high interobserver and intraobserver reliability when used by orthopedic surgeons with experience in treating Jul 30, 2024 · Beginning in France in the 1960s, the management of acetabular fractures has increasingly evolved toward surgical treatment strategies. Jul 1, 2018 · The fracture was surgically treated with a customized plate via the lateral rectus approach. 1964; 46 :1615–1646. Jul 1, 2015 · Marked progress has been made after a systematic approach and treatment algorithm were proposed by Judet et al. has been shown to be clinically useful because it outlines a plan of treatment. A stepwise approach has been Oct 21, 2020 · Approach to the management of displaced acetabular fractures has evolved from conservative to operative management after the work of Judet and Letournel. In these cases, an extensile approach will provide adequate access to the roof of the acetabulum for anatomic restoration of its articular surface. Jun 20, 2024 · The acetabulum is a complex three dimensional innominate bone that comprises an anterior and posterior column and a roof. 15. The basic principles established by the pioneers of acetabular surgery, Letournel and Judet - anatomical reconstruction of the joint and stable osteosynthesis - remain unchanged. posterior glenoid rim. At the time, Letournel had international notoriety for his pioneering work with surgical May 16, 2024 · However, the Judet-Letournel classification system still has limitations in classifying acetabular fractures , and currently, QLP is often adopted as a separate classification system . Jan 1, 2022 · At present, although none of the research can influence the status of Judet-Letournel classification, it supplements some deficiencies of Judet-Letournel classification to a certain extent, and advances clinical orthopedists to deepen understandings of QP fractures, so as to help them choose more appropriate operative approaches, fixation Oct 3, 2016 · さて、寛骨臼骨折の分類は、The Judet and Letournel classification for acetabular fracturesが有名です。 この分類は下記のごとくで、2つの大きなカテゴリーに分類されます。 Mar 23, 2023 · The 'Judet view' is a two-part view of the acetabulum, the collimation of the Judet views is departmentally dependent. Aug 23, 2013 · In the Judet-Letournel classification system, acetabular fractures are classified into two broad categories: elementary and associated fractures. In his youth, his uncle taught him carpentry and he became facile with a saw, a skill that served him well in his later life as an orthopedic surgeon. Letournel E, Judet R. Hufner et al. The extended iliofemoral approach was developed by Letournel in May 8, 2020 · The anatomic and radiographic classification proposed by Judet et al. Fractures were classified according to Judet-Letournel. scapular neck. . After a background understanding of the classification of Judet and Letournel and the radiographic anatomy of the pelvis, the majority of acetabular fractures are readily classified by utilizing the steps as outlined above. The demographic characteristics of the study included region-wise distribution of acetabular fractures by age, sex, associated Sep 12, 2019 · Observation of the fracture lines of the quadrilateral plate based on fracture mapping can help orthopedic surgeons to enhance the understanding of the Judet-Letournel classification, which may have some significant guidance on the choice of operation approach and the design of internal fixation devices. His lifelong contributions to understanding the classification of fracture patterns, creation of the orthopaedic trauma specialty of pelvic and acetabular surgery, and the documentation of the long-term results of operative treatment of acetabular fracture surgery laid the Feb 2, 2024 · In orthopaedic surgery, as well as other areas in medicine, it is common for a surgical technique to carry the original authors’ name describing the procedure. This approach can fully expose the anterior column, the surface of the square area and the upper and lower branches of the pubic bone, while not interfering with the hip abductors, which is conducive to the early rehabilitation of patients. glenoid osteotomy. 4) and Letournel and Judet 5) in the 1960s. Jul 21, 2023 · e bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. We compared the use of 3-D printed models of acetabular fractures to the current standard use of CT scans. Letournel was the number one authority in the world on acetabular fractures but he had also studied under Dr. New York, SpringerVerlag, 1993; 364-73. 1, 2 We presented a case of isolated fracture of the quadrilateral plate with central hip dislocation that does not fit into the existing classification. However meticulous dissection is required to prevent injury to major Jan 1, 1993 · The pioneering work by Judet and Letournel affords a scheme by which fracture pattern delineation and selec- tion of an appropriate surgical approach can be facili- tated. Various surgical methods have been explored and described by authors to address this type of fracture, leading to improved clinical outcome. We feel that a systematic, stepwise approach to classifying acetabular fractures into larger groups and then subclassifying these groups will help simplify the application of the Letournel and Judet classification. MeSH terms Accidents* Accidents, Traffic* Acetabulum* Jul 7, 2023 · The most influential papers were by Matta (1996), Judet et al (1964), Letournel et al (1993), Letournel (1980), Giannoudis et al (2005), Brooker et al (1973), Matta et al (1986), Mears et al (2003), and Ferguson et al (2010) as measured by the number of co-citations across all analyzed studies. Based on a standard radiographic examination (AP and Judet oblique views) and most recently on CT scan studies this classification constitutes the first step in surgical decision making. In quite a spontaneous manner, Robert Judet (1909–1980) [4, 5] and his brother Jean Judet (1905–1995) used their father’s orthopedic table to perform hip surgery in 1947 [], and, of course, through the usual approach, i. Jun 12, 2024 · The Judet and Letournel system for acetabular fractures is the most widely used classification system in clinical practice. Jun 6, 2020 · This atypical acetabular anterior wall fracture is different from the Judet-Letournel classification in terms of morphology and surgical procedure. doi: 10. However, for orthopaedic surgeons with less experience with these fractures, correct classification can be more difficult. Jul 1, 2023 · However, the classical Judet−Letournel classification does not include QLP fractures, which would limit the surgeon's perception of QLP fractures and make them easy to ignore. Reginald AE. Jul 28, 2019 · Since 1965, this new approach was frequently and successfully used by Judet and Letournel and has become the gold standard in the treatment of anterior column fractures [5,6,7]. LETOURNEL R. 1) that allowed most orthopedic procedures. Fractures of the acetabulum: classification and surgical approaches for open reduction. Try using this method, and your ability to classify these fractures will improve. Additional classification systems include: AO/OTA classification of acetabular fractures. Robert Judet. Early and final radiological evaluation was based on Matta’s criteria. As an intrapelvic approach, it became popular for Download scientific diagram | The Judet and Letournel acetabular fracture classification system from publication: Acetabular Fractures in the Elderly: Treatment Recommendations | Acetabular Sep 2, 2020 · Out of 32 patients, two were lost in follow up, leaving 30 of 32 patients for clinico-radiological analysis. Judet and Letournel classification for acetabular fractures Apr 15, 2019 · After initial work done by Judet 1 and Letournel 2 who described the classification system and approaches, various modifications of approaches have been developed to improve outcome. The most common type of acetabular fracture based on Judet-Letournel classification in this study is both columns (59. Jul 28, 2024 · After finding existing approaches to the anterior acetabulum to be inadequate, Emile Letournel (2) returned to the historic Paris anatomy institute, the Fer à Moulin, where he developed the II approach. org In this review, we present the literature related to the Judet and Letournel acetabular fracture classification system, over 50 years after its first formal description. Considering the limitations of the Judet-Letournel classification, we propose a 3-column classification as the basis for evaluating QLP fractures. See full list on radiopaedia. Treatment for this complex situation is particularly Jun 29, 2013 · Our thanks are due to our new publishers, Springer-Verlag, for their keen interest and skill. Sep 12, 2019 · The Judet-Letournel classification [7, 8] has been widely accepted for classifying acetabular fractures, communicating with peers, selecting surgical approach, and reporting results [12–14]. The surgical exposure allows the development of three working windows: The first (lateral) window extends between the sacro-iliac joint and the iliopsoas, providing Oct 14, 2020 · Ilio-inguinal approach has been the standard approach for anterior acetabulum fractures since it was first described by Letournal et al. Jul 21, 2023 · The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma Professor Emile Letournel, at the peak of his career, was the leading pelvic and acetabular fracture surgeon in the world. ” Judet was the founder of the anterior approach method and performed the first hip replacement of that kind in Paris in 1947. Mar 3, 2018 · Several systems are available for the classification of acetabular fractures (Arbeitsgemeinschaft für Osteosynthesefragen [AO], Harris, etc. 1%), most commonly treated by surgery. Overview. Fractures of acetabulum. The innovation of the approach was that in opening the inguinal canal at its roof and floor for access to The Judet-Letournel classification proposed in 1964 and refined in 1974 has stood the test of time and remains the most common and practical way of classifying acetabular fractures. Sep 12, 2024 · The anteroposterior and oblique views radiographs were used to classify acetabular fractures as per the Judet and Letournel classification, which was further confirmed by Non Contrast Computed Tomograpy (NCCT) scans 12. May 12, 2022 · In the 1930s, Henri Judet (1874–1943) developed a special table (Fig. E. In Mar 22, 2024 · In total, 63% of cases were recorded as unclassifiable by at least one surgeon, and 46% by at least two in the Hutt et al. Case 1 is a male 55 years old, injured in a motor vehicle accident who had a pelvic fracture, especially a quadrilateral surface fracture in conjunction with high anterior column fracture. Interobserver concordance of the Judet and Letournel classification was found to increase in direct relation to the surgeon's experience, regardless of the addition of the oblique views. 8 This format, by scrutinizing reproducible radio- graphic landmarks, designates fractures according to involvement to one or both columns. Diagnosis can be made radiographically with dedicated pelvis radiographs (including Judet views) but frequently require CT pelvis for surgical planning. , the anterior approach. The “boomerang” incision follows the curve of the scapula spine and vertebral border, and fixation occurs through an intermuscular window. In particular, high angle transtectal fractures Sep 19, 2016 · However, there are four types complex acetabular fractures involving two columns including transverse fractures, associated transverse and posterior wall fractures, T-shape fractures and both-column fractures, according to the Judet and Letournel classification system (Letournel 1980). The aim of this historic review is to outline the genealogy of the orthopaedic arm of the Judet family, while Sep 5, 2017 · At that time Dr. Study. 9 The Letournel and Judet classification system could be fail with acetabulum fractures which do not match the fracture lines described by Letournel and Judet, especially when quadrilateral surface fracture is Jun 4, 2011 · The Letournel and Judet classification system is commonly used for classifying acetabular fractures. 5-7 Adequate treatment of acetabular fractures requires an accurate definition of the type of Feb 18, 2021 · The Judet-Letournel classification demonstrated only moderate rates of agreement. Based on the widely-used Judet and Letournel classi cation [18], indications of such a simpli ed anterior approach include the elementary and associated displaced acetabular fractures involving Jun 1, 2014 · Emile Letournel et Robert judet [1] ont codifié le traitement chirurgical des fractures de l’acétabulum, grâce à une description radiographique exhaustive des lésions. We feel that a systematic, stepwise approach to classifying acetabular fract … On December 4, 1927, Emile Letournel was born in the archipelago of Saint Pierre et Miquelon, France, located south of Nova Scotia. We aim to summarize its strengths, weaknesses, and its place in our current understanding of acetabular fractures and their recommended management. The use of 3-D printed models increased the inter-observer agreement rates with respect to fracture classification, but decreased it with respect to the preferred surgical approach. Delayed reconstruction of acetabular fractures 21-120 days following injury. La voie ilio-inguinale a été introduite en 1961 pour le traitement des lésions de la paroi et de la colonne antérieure et de certaines lésions récentes parmi les At the request of our publishers, I accepted the task of preparing this second edition. Cette approche constitue un excellent choix qui offre une bonne exposition peropératoire du cotyle s´étendant de la colonne antérieure jusqu´à la partie supérieure de la colonne postérieure; elle permet ainsi d´obtenir de bons résultats fonctionnels avec des mains May 4, 2021 · In the classic work of Judet and Letournel, the ilioinguinal approach was described in detail. proposed guidelines to increase the reliability and validity of Letournel’s classification. 90% , and Letournel and Judet 77% ), confirming that the posterior approach is effective in treating most of these fractures, but it requires appropriate indications. Indications. We classified the fracture pattern according to Judet and Letournel classification based on preoperative X-ray AP view, Judet View, and 3D-CT pelvis. Apr 26, 2024 · Acetabular fractures, often caused by high-energy mechanisms, were historically treated non-operatively and had a poor prognosis before the 1960s. Acetabulum fractures are pelvis fractures that involve the articular surface of the hip joint and may involve one or two columns, one or two walls, or the roof within the pelvis. Ilioinguinal approach was originally described by Letournel 3 in 1961 for fixation of fracture acetabulum. 16. Modern advancements in surgical techniques aim to reduce access-related trauma Feb 2, 2021 · We evaluated the intra and inter-observer reliability of the Judet-Letournel classification system, with respect to fracture classification and preferred surgical approach. Feb 1, 2019 · The Judet and Letournel acetabular fracture classification system, based on the idea of bicolumnar support of the acetabulum, was first described in a landmark article published in the 1960s. The Kocher-Lengenbeck approach. 1,2 However, in 1963, Judet and Letournel published a seminal study recommending open reduction and internal fixation for certain acetabular fractures, marking a significant shift in treatment May 12, 2022 · My first exposure to Anterior Approach primary hip was in 1981 with Professor Emile Letournel, a former resident of Robert Judet, at his hospital in Paris at Port de Choisy. Preliminary report. eshv bxyt snq jwjenh hzi byqzioq irh oyvomz fxyvqm uwmrn