Parameters affecting the outcome of acetabular fracture, which occur due to high energy trauma, have high mortality and morbidity rates and are commonly treated by surgical intervention are age, level of osteoporosis, complexity of fracture, existence of accompanying injuries and application of a thorough and suitable treatment approach. To determine the proper treatment modality, accurate classification of fracture is mandatory. Widely used Letournel and Judet classification system of acetabular fracture is based on the fracture lines at the graphies. Standard radiological examination of acetabulum fracture comprises anteroposterior pelvis and Judet`s graphies. While taking iliac and obturator graphies described by Judet, it is important to provide right angle between X-ray source and cassette by turning the patient 45 degrees on intact and fractured side. Computed tomography has superiority to X-ray at detection of intra-articular fragments, evaluation of joint congruency and determination of rotation of fragments. This is an important advantage in determination of treatment programme. To control the data obtained from computed tomography and acetabular series by a checklist will facilitate the diagnosis and classification of fracture. At this stage; answers to the following eight questions will probably result in true diagnosis, proper treatment and succesfull functional outcome.
1. Is there a fracture of the obturator ring?
2. Is the ilioischial line disrupted?
3. Is the iliopectineal line disrupted?
4. Is the iliac wing above the acetabulum fractured?
5. Is the posterior wall fractured?
6. Does the fracture divide the acetabulum into top and bottom halves or front and back halves?
7. Can an intact strut of bone be followed from the sacroiliac joint to the acetabular articular surface or is a spur sign present?
8. What is the orientation of the major fracture line on computed tomography?