Secure Screw Placement in Management of Acetabular Fractures Using the Suprapectineal Quadrilateral Buttress Plate

Egli, Rainer J.; Keel, Marius; Cullmann, Jennifer; Bastian, Johannes Dominik

doi:10.1155/2017/8231301

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…In terms of acetabular fracture fixation, a recently developed supra-pectineal plate was used in our case for fixing the anterior column with quadrilateral surface disruption for the right acetabulum. This was developed to prevent medial displacement of the femoral head post fixation and demonstrated no intra-articular screw placement in a retrospective study involving 30 plates 11…”

Section: Discussionmentioning

confidence: 99%

Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management

Mohamed

Makaranka²,

Cheema

et al. 2019

BMJ Case Rep

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Bilateral acetabular fractures following epileptic seizures are a rare but known occurrence in adults, with an 18.5% mortality rate. These fractures occurring post epileptic seizures have not been previously documented in children. We report a case of a 13-year-old boy who presented to hospital via ambulance following two violent generalised tonic–clonic seizures in a postictal state, metabolically acidotic and a low haemoglobin. Acute abdomen was suspected and the patient underwent a CT scan which showed bilateral acetabular fractures with central dislocations of both femoral heads and free fluid in the abdomen. The patient underwent initial damage control intervention with insertion of bilateral distal femur skeletal traction. Definitive fixation of the acetabular fractures occurred 1 week later with an open reduction internal fixation with novel supra-pectineal plates using a Pfannenstiel incision. We use this report to increase awareness of significant pelvic injuries in paediatric patients post epileptic seizures.

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Section: Discussionmentioning

confidence: 99%

Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management

Mohamed

Makaranka²,

Cheema

et al. 2019

BMJ Case Rep

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“…Well-established fracture fixation methods include various combinations of pelvic reconstruction plates and lag screws. Newer buttress plate constructs, which cover the posterior and anterior columns through the quadrilateral surface, have been developed to take advantage of the exposure of both columns provided by the AIP [13][14][15][16]. Providing medial buttressing to the posterior column and quadrilateral surface may be beneficial in terms of stability and prevention of medial subluxation when compared with traditional fracture fixation techniques [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…Newer buttress plate constructs, which cover the posterior and anterior columns through the quadrilateral surface, have been developed to take advantage of the exposure of both columns provided by the AIP [13][14][15][16]. Providing medial buttressing to the posterior column and quadrilateral surface may be beneficial in terms of stability and prevention of medial subluxation when compared with traditional fracture fixation techniques [15,16]. While the conventional plates are either shaped in a straight or curved fashion, more recently buttress plates were introduced as three-dimensional shaped plates to fit anatomically to the periacetabular region [9].…”

Section: Introductionmentioning

confidence: 99%

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Hartel

Naji

Fensky

et al. 2021

Arch Orthop Trauma Surg

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Purpose To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. Patients and methods A consecutive case series of 50 acetabular fractures (patient age 69 ± 23 years) treated with suprapectineal anatomic plates were analyzed in a retrospective study. The analysis included: Mechanism of injury, fracture pattern, surgical approach, need for additional total hip arthroplasty, intra- or postoperative complications, as well as bone mass density and radiological outcome on postoperative computed tomography. Results Most frequently, anterior column fracture patterns with and without hemitransverse components as well as associated two column fractures were encountered. The anterior intrapelvic approach (AIP) was used in 98% (49/50) of the cases as primary approach with additional utilization of the first window of the ilioinguinal approach in 13/50 cases (26%). Determination of bone density revealed impaired bone quality in 70% (31/44). Postoperative steps and gaps were significantly greater in this subgroup (p < 0.05). Fracture reduction quality for postoperative steps revealed anatomic results in 92% if the bone quality was normal and in 46% if impaired (p < 0.05). In seven cases (14%), the plate was utilized in combination with acute primary arthroplasty. Conclusion A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.

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“…A dissociation of the anterior column to the posterior column followed by a medialization of the quadrilateral surface has been identified as a risk factor for a secondary dislocation leading to a so called "central subluxation" of the femoral head [2][3][4]. As a consequence, a number of advancements concerning anterior approaches and fixation techniques have been made recently [2,[5][6][7][8][9][10]. Anatomically precontoured plate systems can provide enhanced reduction and fixation properties [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…As a consequence, a number of advancements concerning anterior approaches and fixation techniques have been made recently [2,[5][6][7][8][9][10]. Anatomically precontoured plate systems can provide enhanced reduction and fixation properties [10,11]. Plate systems with a buttress to support the quadrilateral surface provide increased periacetabular stability [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Surgical Drill Guide for Insertion of an Infra-Acetabular Screw Based on an Anatomically Precontoured Plate System: A Cadaveric Study

Freigang¹,

Gottsauner

Rupp³

et al. 2021

BioMed Research International

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Purpose. Due to the anatomic structure of the pelvis, free-hand placement of screws in the acetabular fracture management can be difficult. Infra-acetabular screw fixation increases acetabular stability by distal fixation of the cup. Aim of this cadaveric study is to investigate if a plate-referenced drill guide can provide save placement of an infra-acetabular screw over a precontoured suprapectineal quadrilateral buttress plate (SQBP). Methods. We constructed a drill guide for an infra-acetabular screw based on the surface of an anatomically precontoured SQBP. A total of 12 adult cadaveric acetabular specimens were used for drill guide-assisted placement of the infra-acetabular screw. The drill guide contains a radiopaque spiral to allow longitudinal fine adjustment of the SQBP along the pelvic brim to assure correct position of the plate-drill-guide construct in relation to the Koehler’s teardrop. After screw placement, we conducted a computed tomography (CT) scan of all specimens to assess the actual position of the screw in relation of the infra-acetabular corridor and the acetabular joint surface. Results. The position of the screw was within the infra-acetabular corridor in all cases. We did not see any intra-articular or intrapelvic screw penetration. The mean distance of the centerline of the screw to the medial border of the infra-acetabular corridor was 3.35 mm. The secure distance to the virtual surface of the femoral head to was 7.3 mm. Conclusions. A plate-referenced drill guide can provide safe placement of an infra-acetabular screw for treatment of acetabular fractures. Radiographic fine adjustment is necessary to access the optimal entry point.

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Secure Screw Placement in Management of Acetabular Fractures Using the Suprapectineal Quadrilateral Buttress Plate

Cited by 12 publications

References 18 publications

Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management

Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Surgical Drill Guide for Insertion of an Infra-Acetabular Screw Based on an Anatomically Precontoured Plate System: A Cadaveric Study

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