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Abstract Objective To explore the reliability and repeatability of the improved classification of acetabular fractures based on the concept of three-column structure.Methods Clinical data of 108 patients with acetabular fracture admitted to Gaochun Branch of Nanjing Guou Hospital from August 2016 to August 2020 were included in this study.TheLetourne-Judet classification and modified acetabular fracture classification were performed by 4 orthopedic surgeons who had practicedfor more than 5 years according to the X-ray and 3D CT data of the patients.Three months later，the second typing was performed，and the reliability and reproducibility of the two typing methods were analyzed by consistency Kappa test.Results Using the modified acetabular fracture classification，all 108 acetabular fractures could be included.However，an average of 7.25 cases could not be included by Letournel-Judetclassification.For improved acetabular fracture classification，the Kappa mean value of credibility test by different doctors at the same time point was 0.891.The Kappa value of reproducibility at different time points for the same physician was 0.938.The average reliability of Letournel-Judet classification was 0.857.The reproducibility was 0.897.The reliability and reproducibility of the modified acetabular fracture classification were slightly higher than that of the Letournel-Judet classification，and both the reliability and reproducibility of the two methods reached excellent grade.Conclusion The improved classification of acetabular fractures based on the concept of three pillars has high reliability and repeatability and can better include all types of acetabular fractures，and can better help physicians to classify acetabular fractures and make treatment plans in clinical practice.
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