Comminuted quadrilateral plate fracture fixation through the iliofemoral approach

Sen, Ramesh Kumar; Trıpathy, Sujit Kumar; Aggarwal, Sameer; Goyal, Tarun; Mahapatra, Santosh

doi:10.1016/j.injury.2012.11.002

Cited by 30 publications

(25 citation statements)

References 12 publications

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“…To achieve direct fixation of quadrilateral plate fractures through an anterior approach, some scholars have conducted studies based on anterior reconstruction plates, and a variety of methods have been described. Letoumel et al achieved good effect combined with a lag screw fixation in the posterior column but also could not directly fix the fracture fragments of the quadrilateral plate; it is difficult to insert the screw, especially when the fracture is comminuted or there is severe osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is extremely difficult to fix the quadrilateral plate directly using screws, and slightly improper manipulation can cause screws to penetrate into the hip. To overcome these problems, several authors have proposed new fixing strategies, including an infrapectineal plate and several novel quadrilateral surface buttress or spring plates to support quadrilateral plate. However, the abovementioned fixation methods cannot directly fix the fracture fragments of quadrilateral plate, which may reduce the reliability of fixation.…”

Section: Introductionmentioning

confidence: 99%

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Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System

Shang

Cai

et al. 2020

Orthopaedic Surgery

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Objectives: To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior platescrew system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.Methods: A total of 32 patients with acetabular fractures, managed by DAPSQ with "quadrilateral screws" through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow-up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System

Shang

Cai

et al. 2020

Orthopaedic Surgery

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“…Minimal bone stock, proximity to the hip joint with limited surgical access and difficulty in obtaining stable fixation contribute to surgical challenges of open reduction and internal fixation of these fractures. 11 Fixation of a medial buttress plate in an infrapectenial fashion is inadequate to buttress all the fragments in communited quadrilateral plate fractures. Hence, a spring plate in a 90-90 construct is fixed underneath the infrapectenial buttress plate.…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of surgical management of comminuted quadrilateral plate acetabulum fractures

2019

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Background: The acetabular quadrilateral fractures are difficult to treat and ORIF using a spring plate buttressing the quadrilateral surface underneath an iliopectenial plate in a 90-90 construct. The aim of the study was to assess the clinical and radiological outcome, success rate and proportion of the post-operative complications of surgical management of comminuted quadrilateral plate acetabulum fractures after ORIF.Methods: It was a hospital based descriptive type of observational study conducted in the Department of Orthopedics, SMS Medical College. The data collection was done from May 2016 up to June 2018. The sample size was 31 for the study purpose, at 95% confidence limits and 20% relative allowable error.Results: We studied 31 patients of communited quadrilateral plate fractures, who were evaluated preoperatively and optimized. ORIF was performed. The mean blood loss was 450 ml and the mean operating time was 130 minutes. The patients were followed up at 1 year postoperatively where 24 patients had an excellent to good Harris Hip clinical score and 24 patients had an excellent to good Matta radiological score, and both were found to be statistically significant.Conclusions: Comminuted quadrilateral plate fractures of the acetabulum are managed surgically by ORIF using a spring buttressing plate beneath the infrapectenial plate. The clinical and radiological follow up for one year duration scores showed good scores which were statistically significant, indicating the success of quadrilateral fixation using this technique.

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“…Other authors have also reported a successful retention of the medial wall with a medial buttressing plate (1/3 semi-tubular, H-plate [12], reconstruction plate [10], Tplate [37]) with the short limb placed under the reconstructive iliopectineal plate and the long one buttressing the quadrilateral lamina. Culemann et al, [12] have compared different fixation techniques with conventional reconstructive plates, with or without medial buttressing plates, and locking implants in a biomechanical study, and concluded that both techniques ensure a sufficient stabilization of the medial wall to prevent a protrusion of the quadrilateral plate.…”

Section: Biomechanicsmentioning

confidence: 99%

The Ilioinguinal Approach versus the Anterior Intrapelvic Approach to the Acetabulum: A Review

Hasani

Kaftandziev

Trpeski

et al. 2013

Open Access Maced J Med Sci

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The ilioinguinal approach (IIA) to the acetabulum has been used as a golden standard for fifty years to treat “anterior” acetabular fractures. Since its introduction by Hirvensalo and Cole, the anterior intrapelvic approach (AIPA) has been adopted by some surgeons, whilst others remain devoted to the IIA. IIA is routinely used in the Republic of Macedonia. The aim of this study is to present a review of literature for two different anterior approaches for the treatment of acetabular fractures used in modern day surgery, focussing on AIPA and its priorities and comparing it to IIA.We performed a search, mainly electronically, and retrospective analysis of existing literature. We have identified and selected two representative and well-systematized papers for IIA, and six for AIPA. We presented the advantages and disadvantages, priorities and weaknesses of both approaches separately, comparing complications, risks and results. Based on the facts presented regarding the advantages of AIPA with a focus on visualization, accessibility and biomechanical justification, the approach should be implemented in our everyday practice and we are comfortable in stating this preference, especially due to the fact that upon comparison of the complication rate there is no significant difference between the two approaches

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Comminuted quadrilateral plate fracture fixation through the iliofemoral approach

Cited by 30 publications

References 12 publications

Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System

Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System

Outcome analysis of surgical management of comminuted quadrilateral plate acetabulum fractures

The Ilioinguinal Approach versus the Anterior Intrapelvic Approach to the Acetabulum: A Review

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