{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T18:19:45Z","timestamp":1783621185538,"version":"3.55.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A transitional \u201cgrey-zone\u201d exists between typical locations of classical trapezoidal anterior wall and large-fragment posterior wall acetabular fractures. Part of this grey zone is the superior acetabular dome, which is commonly involved in acetabular fracture patterns, especially in geriatric patients. The aim of this study was to characterize isolated acetabular superior wall fractures and to assess their relevance as a distinct fracture pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of pelvic fracture databases from three tertiary trauma centers was performed. Acetabular fractures with superior dome involvement were screened, and cases with isolated superior articular involvement were included. Overall, seven patients were identified. Clinical and radiological data were analyzed regarding fracture morphology, associated fracture characteristics (including dislocation, comminution, marginal impaction, intra-articular fragments, and femoral head injury), concomitant pelvic ring injuries, treatment, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Isolated superior wall acetabular fractures occurred following both high-energy and low-energy mechanisms, including simple falls. The mean age was 48 years and four of seven patients were male. Hip dislocation or subluxation was observed in four cases (anterior-superior or purely superior). Surgical treatment was performed in six cases, predominantly using anterior approaches (mainly the iliofemoral approach) with screw and\/or plate fixation. Outcomes were frequently unfavorable, with relevant joint degeneration or persistent symptoms, likely related to substantial articular damage of the superior weight-bearing zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acetabular superior wall fractures present a distinct fracture pattern that differs from classical anterior and posterior wall fractures and is less commonly observed. These injuries involve the superior weight-bearing dome and are frequently associated with comminution and substantial articular damage of both the acetabulum and femoral head. Even in cases with restored joint congruence, outcomes appear inferior, underscoring the clinical relevance of this fracture entity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06407-z","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:47:14Z","timestamp":1783619234000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acetabular superior wall fractures: a distinct acetabular fracture entity"],"prefix":"10.1007","volume":"146","author":[{"given":"Axel","family":"G\u00e4nsslen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Krappinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Liodakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Dierk","family":"Clausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Omar-Pacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Lindtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Sehmisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Osche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"6407_CR1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1136\/ard.43.2.295","volume":"43","author":"N Afoke","year":"1984","unstructured":"Afoke N, Byers P, Hutton W (1984) The incongruous hip joint: a loading study. Ann Rheum Dis 43:295\u2013301","journal-title":"Ann Rheum Dis"},{"key":"6407_CR2","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1007\/s00402-011-1299-0","volume":"131","author":"J Bastian","year":"2011","unstructured":"Bastian J, Turina M, Siebenrock K, Keel M (2011) Long-term outcome after traumatic anterior dislocation of the hip. Arch Orthop Trauma Surg 131:1273\u20131278","journal-title":"Arch Orthop Trauma Surg"},{"key":"6407_CR3","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1016\/j.otsr.2020.02.014","volume":"106","author":"W Cai","year":"2020","unstructured":"Cai W, Xie Y, Su Y (2020) Comparison of non-surgical and surgical treatment using absorbable screws in anterior-superior iliac spine avulsion fractures with over 1.5\u00a0cm displacement. Orthop Traumatol Surg Res 106:1299\u20131304","journal-title":"Orthop Traumatol Surg Res"},{"key":"6407_CR4","doi-asserted-by":"publisher","first-page":"3795","DOI":"10.1016\/j.injury.2022.08.033","volume":"53","author":"K Dara","year":"2022","unstructured":"Dara K, Bere T, Hellund J, Flugsrud G, Roise O (2022) Long-term results after isolated iliac wing fractures. Injury 53:3795\u20133799","journal-title":"Injury"},{"key":"6407_CR5","doi-asserted-by":"publisher","first-page":"103209","DOI":"10.1016\/j.otsr.2022.103209","volume":"108","author":"P Desauge","year":"2022","unstructured":"Desauge P, Aubert T, Marteau V, Upex P, Jouffroy P, Riouallon G (2022) Identification and treatment of atypical acetabular fractures having an independent acetabular roof fragment: three-column fractures. Orthop Traumatol Surg Res 108:103209. https:\/\/doi.org\/10.1016\/j.otsr.2022.103209. (Epub Date: 20220122)","journal-title":"Orthop Traumatol Surg Res"},{"key":"6407_CR6","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.2214\/ajr.165.5.7572506","volume":"165","author":"R Erb","year":"1995","unstructured":"Erb R, Steele J, Nance E, Edwards J (1995) Traumatic anterior dislocation of the hip: spectrum of plain film and CT findings. AJR Am J Roentgenol 165:1215\u20131219","journal-title":"AJR Am J Roentgenol"},{"key":"6407_CR7","doi-asserted-by":"publisher","unstructured":"Freude T, G\u00e4nsslen A, Krappinger D, Lindahl J (2024) Quadrilateral plate fractures. Arch Orthop Trauma Surg 145:51. https:\/\/doi.org\/10.1007\/s00402-024-05698-4. (epubdate 20241216)","DOI":"10.1007\/s00402-024-05698-4"},{"key":"6407_CR8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1302\/0301-620X.54B1.157","volume":"54","author":"A Greenwald","year":"1972","unstructured":"Greenwald A, Haynes D (1972) Weight-bearing areas in the human hip joint. J Bone Joint Surg Br 54:157\u2013163","journal-title":"J Bone Joint Surg Br"},{"key":"6407_CR9","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/0021-9290(71)90041-8","volume":"4","author":"A Greenwald","year":"1971","unstructured":"Greenwald A, O\u2019Connor J (1971) The transmission of load through the human hip joint. J Biomech 4:507\u2013528","journal-title":"J Biomech"},{"key":"6407_CR10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.13107\/jocr.2025.v15.i11.6308","volume":"15","author":"H Haider","year":"2025","unstructured":"Haider H, Bava S, Phunde R, Chaudhari K, Somani R, Kalsekar R (2025) Superior acetabular fracture: a rare variant involving both anterior and posterior walls. J Orthop Case Rep 15:69\u201372","journal-title":"J Orthop Case Rep"},{"key":"6407_CR11","first-page":"19","volume":"81","author":"I Hasegawa","year":"2022","unstructured":"Hasegawa I, Hasegawa M, Livingstone J, Kane T, Lee L (2022) What\u2019s new in geriatric acetabular fractures? Hawaii J Health Soc Welf 81:19\u201324","journal-title":"Hawaii J Health Soc Welf"},{"key":"6407_CR12","first-page":"510","volume":"85","author":"E Hermans","year":"2019","unstructured":"Hermans E, Edwards M, Biert J (2019) Isolated iliac wing fractures: are they really that benign? Acta Orthop Belg 85:510\u2013515","journal-title":"Acta Orthop Belg"},{"key":"6407_CR13","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.2106\/00004623-196446080-00001","volume":"46","author":"R Judet","year":"1964","unstructured":"Judet R, Judet J, Letournel E (1964) Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 46:1615\u20131646","journal-title":"J Bone Joint Surg Am"},{"key":"6407_CR14","volume-title":"Les fractures du cotyle","author":"R Judet","year":"1974","unstructured":"Judet R, Letournel E (1974) Les fractures du cotyle. Masson & Cie, Paris"},{"key":"6407_CR15","doi-asserted-by":"publisher","first-page":"4515","DOI":"10.1007\/s00402-024-05312-7","volume":"144","author":"D Krappinger","year":"2024","unstructured":"Krappinger D, Freude T, Stuby F, Lindtner R (2024) Acetabular fractures in geriatric patients: epidemiology, pathomechanism, classification and treatment options. Arch Orthop Trauma Surg 144:4515\u20134524","journal-title":"Arch Orthop Trauma Surg"},{"key":"6407_CR16","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/BF00316645","volume":"150","author":"H Kurrat","year":"1977","unstructured":"Kurrat H (1977) Die Beanspruchung des menschlichen H\u00fcftgelenks. VI. Eine funktionelle Analyse der Knorpeldickenverteilung am menschlichen Femurkopf. Anat Embryol (Berl) 150:129\u2013140","journal-title":"Anat Embryol (Berl)"},{"key":"6407_CR17","first-page":"145","volume":"126","author":"H Kurrat","year":"1978","unstructured":"Kurrat H, Oberlander W (1978) The thickness of the cartilage in the hip joint. J Anat 126:145\u2013155","journal-title":"J Anat"},{"key":"6407_CR18","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1097\/BOT.0b013e31814612e5","volume":"21","author":"J Lenarz","year":"2007","unstructured":"Lenarz J, Moed B (2007) Atypical anterior wall fracture of the acetabulum: case series of anterior acetabular rim fracture without involvement of the pelvic brim. J Orthop Trauma 21:515\u2013522","journal-title":"J Orthop Trauma"},{"key":"6407_CR19","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-02325-9","volume-title":"Fractures of the acetabulum. 2nd Edition","author":"E Letournel","year":"1981","unstructured":"Letournel E, Judet R (1981) Fractures of the acetabulum, 2nd edn. Springer-Verlag, Berlin","edition":"2"},{"key":"6407_CR20","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-75435-7","volume-title":"Fractures of the acetabulum","author":"E Letournel","year":"1993","unstructured":"Letournel E, Judet R (1993) Fractures of the acetabulum, 2nd edn. Springer-Verlag, Berlin","edition":"2"},{"key":"6407_CR21","doi-asserted-by":"publisher","unstructured":"Meena U, Meena B, Sheikh A, Pradhan S, Tripathy S (2024) Intra-articular anterior inferior iliac spine avulsion with hip instability: a retrospective study. J Clin Orthop Trauma 57 102768. https:\/\/doi.org\/10.1016\/j.jcot.2024.102768. (Epub Date: 20241016)","DOI":"10.1016\/j.jcot.2024.102768"},{"key":"6407_CR22","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1097\/00005373-198811000-00016","volume":"28","author":"Y Mirovsky","year":"1988","unstructured":"Mirovsky Y, Fischer S, Hendel D, Halperin N (1988) Traumatic anterior dislocation of the hip joint with fracture of the acetabulum: a case report. J Trauma 28:1597\u20131599","journal-title":"J Trauma"},{"key":"6407_CR23","doi-asserted-by":"publisher","unstructured":"Oldhoff M, Kamal Z, Ten Duis K, Wubs F, de Vries J, Kraeima J, IJpma F (2024) Semi-automated finite element analyses of surgically treated acetabular fractures to investigate the biomechanical behaviour of patient-specific compared to conventional implants. J Orthop Surg Res. https:\/\/doi.org\/10.1186\/s13018-024-04957-9. (Epub Date 20240905)","DOI":"10.1186\/s13018-024-04957-9"},{"key":"6407_CR24","doi-asserted-by":"publisher","DOI":"10.5005\/jojs-10079-1138","author":"K Paulraj","year":"2024","unstructured":"Paulraj K, Muthu S (2024) Strategies in management of posterosuperior wall fracture of the acetabulum. J Orthop Joint Surg. https:\/\/doi.org\/10.5005\/jojs-10079-1138","journal-title":"J Orthop Joint Surg"},{"key":"6407_CR25","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-14646-6_2","volume-title":"AE-Manual der Endoprothetik","author":"R Putz","year":"2012","unstructured":"Putz R, Simon U, Claes L, N\u00f6tzli H, Wyss T (2012) Funktionelle Anatomie und Biomechanik. In: Claes L, Kirschner P, Perka C, Rudert M (eds) AE-Manual der Endoprothetik. Springer, Berlin\/Heidelberg. https:\/\/doi.org\/10.1007\/978-3-642-14646-6_2"},{"key":"6407_CR26","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.jor.2023.03.004","volume":"38","author":"M Reboli","year":"2023","unstructured":"Reboli M, Aprato A, Vittori J, Olivero M, Bosco F, Masse A (2023) Reevaluation of the surgical indications for anterior inferior iliac spine avulsion fractures in an acute setting\u2014a narrative review of the current literature. J Orthop 38:20\u201324","journal-title":"J Orthop"},{"key":"6407_CR27","doi-asserted-by":"publisher","first-page":"EpubDate2021111","DOI":"10.2106\/JBJS.CC.21.00289","volume":"11","author":"J Richards","year":"2021","unstructured":"Richards J, Overmann A, D\u2019Alleyrand J (2021) Pure superior wall acetabular fracture: a rare posterior wall variant. JBJS Case Connect. https:\/\/doi.org\/10.2106\/JBJS.CC.21.00289. (EpubDate20211117)","journal-title":"JBJS Case Connect"},{"key":"6407_CR28","doi-asserted-by":"publisher","unstructured":"Rommens P, Herteleer M, Handrich K, Boudissa M, Wagner D, Hopf J (2020) Medial buttressing of the quadrilateral surface in acetabular and periprosthetic acetabular fractures. PLoS One 15: e0243592. https:\/\/doi.org\/10.1371\/journal.pone.0243592. (EPUB Date: 20201207)","DOI":"10.1371\/journal.pone.0243592"},{"key":"6407_CR29","doi-asserted-by":"publisher","unstructured":"Saracco M, Ciriello V, Kanakaris N, Giannoudis PV (2026) Isolated acetabular anterior wall fractures: fracture patterns, fixation methods and a new proposed classification system for a rare injury. Injury 57 112958. https:\/\/doi.org\/10.1016\/j.injury.2025.112958. (epub Date: 20251211)","DOI":"10.1016\/j.injury.2025.112958"},{"key":"6407_CR30","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/00005373-198803000-00021","volume":"28","author":"D Sherlock","year":"1988","unstructured":"Sherlock D (1988) Traumatic anterior dislocation of the hip. J Trauma 28:411\u2013413","journal-title":"J Trauma"},{"key":"6407_CR31","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s001130050458","volume":"102","author":"R von Eisenhart-Rothe","year":"1999","unstructured":"von Eisenhart-Rothe R, Witte H, Steinlechner M, Muller-Gerbl M, Putz R, Eckstein F (1999) Quantitative determination of pressure distribution in the hip joint during the gait cycle. Unfallchirurg 102:625\u2013631","journal-title":"Unfallchirurg"},{"key":"6407_CR32","doi-asserted-by":"publisher","first-page":"S26","DOI":"10.1097\/BOT.0000000000002230","volume":"35","author":"M Walters","year":"2021","unstructured":"Walters M, Bergin P, Russell G, Morellato J (2021) Geriatric acetabular fractures and femoral head protrusio: methods of fixation and the option of total hip arthroplasty. J Orthop Trauma 35:S26\u2013S31","journal-title":"J Orthop Trauma"},{"key":"6407_CR33","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1186\/s13018-022-03094-5","volume":"17","author":"B Xiong","year":"2022","unstructured":"Xiong B, Yang P, Lin T, Xu J, Xie Y, Guo Y, Liu C, Zhou Q, Lai Q, He W, Wei Q, Zhang Q (2022) Changes in hip joint contact stress during a gait cycle based on the individualized modeling method of gait-musculoskeletal system-finite element. J Orthop Surg Res 17:267. https:\/\/doi.org\/10.1186\/s13018-022-03094-5. (Epub Date: 20220514)","journal-title":"J Orthop Surg Res"},{"key":"6407_CR34","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.2106\/JBJS.19.00284","volume":"101","author":"R Zhang","year":"2019","unstructured":"Zhang R, Yin Y, Li A, Wang Z, Hou Z, Zhuang Y, Fan S, Wu Z, Yi C, Lyu G, Ma X, Zhang Y (2019) Three-column classification for acetabular fractures: introduction and reproducibility Assessment. J Bone Joint Surg Am 101:2015\u20132025","journal-title":"J Bone Joint Surg Am"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06407-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-026-06407-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06407-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:47:15Z","timestamp":1783619235000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-026-06407-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6407"],"URL":"https:\/\/doi.org\/10.1007\/s00402-026-06407-z","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]},"assertion":[{"value":"20 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Due to the retrospective study design and the use of anonymized routinely collected clinical data, informed consent was not required. The requirement for informed consent was waived by the ethics committee (Nr. 12361-BO-K-2026).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Artificial intelligence (AI) was used in the preparation of this manuscript solely to improve clarity and language. Specifically, the GPT-4 language model by OpenAI was used to assist in refining the text, enhancing readability, and ensuring grammatical accuracy. AI was not used for study design, data collection, data analysis, or interpretation.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of artificial intelligence"}}],"article-number":"253"}}