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Dr. Ebraheim’s educational animated video describes fractures of the acetabulum - posterior column fracture. A posterior column fracture is the disruption of the ischium. The ischial component of the acetabulum is free. The fracture line usually originates at the greater sciatic notch. This can injure the superior gluteal artery and nerve. The fracture line travels across the acetabulum and exits tat the obturator foramen. The ischial pubic ramis is usually fractured. The iliopectineal line is intact and the ilioischial line is disrupted. Medial displacement of the femoral head can occur, which is seen in the iliac view. Medial displacement of the femoral head may look like acetabular protrusio. This injury represents one pattern of posterior hip dislocation that is frequently accompanied by injury to the sciatic nerve. CT scan will show the coronal orientation of the posterior column fracture. In general, column fractures divide the acetabulum into front and back parts. A posterior column fracture is a coronal fracture, or horizontal fracture. A CT scan showing the coronal orientation od the posterior column is different than the oblique orientation of the posterior wall fracture. In general, there is a difference in the orientation of different acetabular fractures on a CT scan. A column fracture, either anterior or posterior, will be horizontal. However, the transverse fracture will appear vertical, or sagittal. Wall fractures will appear oblique. Posterior column and posterior wall fracture is the only associated fracture that does no involve both columns. In this fracture, you reduce the posterior column first, the reduce the posterior wall fracture. Finally, you fix both. Insert the screws for the posterior plate into the safe zone of the acetabulum and away from the danger zone. During posterior approach to the hip, protect the sciatic nerve, which can be injured from the injury or fro the surgery. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC