Outcome analysis of surgical management of comminuted quadrilateral plate acetabulum fractures

Abstract

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results: </strong>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.</p><p><strong>Conclusions:</strong> 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. </p>

Role of combined brim and spring plates in the treatment of acetabular fractures involving quadrilateral plates: a retrospective study of early results

“…As both plates are at right angles to each other, this is called a 90 degree-90 degree construct. 11 The hypothesis in this study was that the combined brim and spring plates could maintain anatomical reduction of QP fractures and give good functional outcomes.…”

“…Adding a suprapectineal brim reconstruction plate gives more force over the spring plate and buttresses the actabular dome beside the quadrilateral surface. As both plates are at right angles to each other, this is called a 90 degree–90 degree construct 11…”