Internal fixation of osteopenic acetabular fractures involving the quadrilateral plate

Laflamme, G. Yves; Hébert‐Davies, Jonah; Rouleau, Dominique M.; Benoit, B.; Leduc, Sylvain

doi:10.1016/j.injury.2010.11.060

Cited by 155 publications

(175 citation statements)

References 28 publications

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“…2,6,11,17,25,[30][31][32][33][34][35][36][37][38][39][40] They report on 353 acetabular fractures of which 213 were treated non-operatively (Table 1) and 140 treated operatively (Table 2). Various radiographic scoring techniques have been used to describe the quality of reduction 18,[41][42][43][44][45] and osteoarthritic changes.…”

Section: Resultsmentioning

confidence: 99%

“…18,41 The most widely used functional scoring systems are the Merlé D'Aubingné -Postel and the Harris hip scores; others include the SF-12, SF-36 and the Musculoskeletal Functional Assessment. 3,11,18,27,42,43,[46][47][48] …”

Section: Resultsmentioning

confidence: 99%

“…2 Central fracture dislocations of the hip with medial migration of the quadrilateral plate are most frequently associated with both-column, anterior column and posterior hemitransverse, posterior column and combined transverse or T-shaped fractures. 5,[9][10][11] They are reported to be more common in the, increasing in numbers, osteoporotic acetabular fractures. [11][12][13][14][15][16][17] These fractures of mainly the elderly population, also pose several specific treatment challenges compared to those of young high-energy trauma patients who are traditionally associated with acetabular fractures.…”

Section: Introductionmentioning

confidence: 99%

“…5,[9][10][11] They are reported to be more common in the, increasing in numbers, osteoporotic acetabular fractures. [11][12][13][14][15][16][17] These fractures of mainly the elderly population, also pose several specific treatment challenges compared to those of young high-energy trauma patients who are traditionally associated with acetabular fractures. 7,12,13,[18][19][20][21][22][23] Until the 1960s most acetabular fractures were treated nonoperatively.…”

Section: Introductionmentioning

confidence: 99%

“…With regards to its anatomical reduction and stable fixation they are difficult to achieve, mainly due to its location in the true pelvis, limited bone stock, juxta-articular nature and its comminution especially in the presence of osteoporosis. 4,6,[10][11][12]28 Failure to restore the buttressing function of the medial wall and reduce the central displacement results in incongruous hip and poor outcome. 6,13,28,29 We present a review of the different treatment modalities and techniques used over the last century, and outcomes in these notoriously challenging central fracture dislocations with quadrilateral plate involvement.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Quadrilateral plate fractures of the acetabulum: An update

White

Kanakaris

Faour

et al. 2013

Injury

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Quadrilateral plate fractures of the acetabulum: An update

White

Kanakaris

Faour

et al. 2013

Injury

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The fascial connections of the pectineal ligament

et al. 2019

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In clinical settings, the pectineal ligament forms a basic landmark for surgical approaches. However, to date, the detailed fascial topography of this ligament is not well understood. The aim of this study was to describe the morphology of the pectineal ligament including its fascial connections to surrounding structures. The spatial-topographical relations of 10 fresh and embalmed specimens were dissected, stained, slice plastinated, and analyzed macroscopically, and in three cases histological approaches were also used. The pectineal ligament is attached ventrally and superiorly to the pectineus muscle, connected to the inguinal ligament by the lacunar ligament and to the tendinous origin of rectus abdominis muscle and the iliopubic tract. It forms a site of origin for the internal obturator muscle, and throughout its curved course, the ligament attaches to both the fasciae of iliopsoas and the internal obturator muscle. However, dorsally, these fasciae pass free from the bone, while the pectineal ligament itself is adhered to it. The organ fasciae are seen apart from the pectineal ligament and its connections. The pectineal ligament seems to form a connective tissue junction between the anterior and medial compartment of the thigh. This ligament, however, is free to other compartments arisen from the embryonal gut and to the urogenital ridge. These features of the pectineal ligament are important to consider during orthopedic and trauma surgical approaches, in gynecology, hernia and incontinence surgery, and in operations for pelvic floor and neovaginal reconstructions. Clin. Anat. 32:961-969, 2019.

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Predictors of clinical outcomes after surgical treatment of displaced acetabular fractures in the elderly

Zha

Sun

Dong

2012

Journal Orthopaedic Research

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ABSTRACT:Outcomes following the open reduction and internal fixation (ORIF) of displaced acetabular fractures in the elderly have been inconsistent. Several factors associated with significant poor clinical outcomes have been reported; however, the factor that contributes independently to the outcomes remains unknown. This study aims to identify independent prognostic factors for the outcomes of surgically treated displaced acetabular fractures in the elderly. A total of 86 elderly patients with displaced acetabular fractures were treated by ORIF between May 1990 and June 2010. Matta's criteria and modified Merle d'Aubigne-Postel score were used as reduction grades and clinical outcome measures, respectively. Reduction grades and six radiographic features were identified as prognostic factors. The six radiographic features include quadrilateral plate fracture, Gull sign, posterior dislocation of hip, femoral head injury (FHI), comminuted posterior wall fracture (CPWF), and posterior wall marginal impaction. The average clinical score of the patients associated with the six radiographic features was 14.4 AE 3.1, whereas the average clinical score for those without was 17.2 AE 1.6 points. The average clinical score of the patients with anatomical, imperfect, and poor reduction were 16.8 AE 2.4, 14.5 AE 2.3, and 11.3 AE 1.4 points, respectively. Multivariate analysis identified three independent predictors of clinical outcomes: reduction grades (t ¼ À10.45, p ¼ 0.000), CPWF (t ¼ À2.74, p ¼ 0.008), and FHI (t ¼ À3.51, p ¼ 0.000). Both CPWF and FHI are important risk factors for clinical outcome. The postoperative quality of reduction independently predicted patient prognosis, and anatomical reduction is predictive of a good prognosis. ß

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Internal fixation of osteopenic acetabular fractures involving the quadrilateral plate

Cited by 155 publications

References 28 publications

Quadrilateral plate fractures of the acetabulum: An update

Quadrilateral plate fractures of the acetabulum: An update

The fascial connections of the pectineal ligament

Predictors of clinical outcomes after surgical treatment of displaced acetabular fractures in the elderly

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