Acetabular both-column fractures: Essentials of operative management

Acetabular both-column fractures are challenging articular injuries. They usually require operative treatment. We report on fundamental elements of pathoanatomy and radiology that are reviewed as far as they may influence treatment planning and surgical intervention. Surgical strategy, choice of the most suitable approach, reduction manoeuvres and fixation techniques are presented, together with some tips and tricks that are worth knowing in the surgical reconstruction of these difficult fractures.