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Displaced Dome Fractures

- Displaced Triangular Dome Fractures:
    - typical large triangular fragment involving the dome portion of articlar cartilage may be displaced and rotated;
    - ORIF is necessary with these fractures;

- High Transverse or T fractures:
    - these shearing type injuries involving the superior portion of dome are extremely difficult to reduce by closed means;

- Displaced Double Column Fracture:
    - in double column fracture (both column fracture), frx of the ilium occurs in coronal plane and may extend directly into joint;
    - CT scan:
         - reveals a coronal frx in the dome (compared to the usual to frx in dome parallel to quadrilateral plate, indicating transverse type fracture