**7.2. Both column fracture**

There are many fracture patterns which involves both column like transverse, T-shaped fracture, transverse with posterior wall but all these fractures have to be differentiated from both column fracture. It is one of the commonest acetabular fracture pattern [13].This fracture is differentiated from all other fracture patterns in that articular surface is completely detached from the remaining portion of the iliac wing which articulate to the sacrum. The anterior and posterior columns separate from each other. It is actually a fracture involving anterior and posterior columns with fracture line extension into the obturator ring and iliac wing. Obturator ring and iliac wing involvement is a must for diagnosing this fracture pattern. Sometimes, CT scan is the only investigation to identify this fracture type. The pathognomonic sign of both column fracture is the presence of spur sign in obturator oblique view, which means the remaining portion of the ilium attached to the sacrum with sciatic buttress is seen projected lateral to the medially displaced acetabulum. Central dislocation of the femoral head is usually seen in the AP view. CT scan shows fracture involving both the columns with disruption of obturator ring and inferior pubic ramus. The main fracture line extending superiorly from the acetabulum into the iliac wing is seen in the coronal plane.
