The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option?

Abstract

Quadrilateral plate reconstruction with a buttress plate though the ilioinguinal approach remains a valid method of fixation in acetabular surgery. Additional studies are needed to compare the efficiency of this method to new surgical approaches and fixation implants.

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

“…Quadrilateral plate fractures are often comminuted, with the femoral head moving into the pelvic cavity with the fragments. These fracture patterns are technically challenging because of the deep site and weak bones. During the operations of this group, we found that fracture fragments of quadrilateral plates often had the tendency of posterior inferior displacement, apart from the inward displacement to the pelvic cavity.…”

“…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. Other scholars have applied the technology of buttress plate, such as the T‐shaped plate, the L‐shaped plate, the butterfly plate, the omega plate, or the one‐third tubular plate to fix quadrilateral fracture. Subsequently, several scholars have reported a successful experience when using a buttress plate for osteopenic acetabular fractures involving the quadrilateral plate.…”

“…To allow early rehabilitation, to improve functional outcomes, and to decrease the risk of posttraumatic arthritis, operative reduction and stabilization have become the “gold standard” for displaced and unstable acetabular fractures. Through long‐term clinical practice, we have found that apart from the simple anterior and posterior wall fractures, there are other types of acetabular fractures, such as those involving both columns, anterior column posterior hemi‐transverse (ACPHT) fractures and T‐shaped fractures, that may involve medial wall fractures of the acetabulum (quadrilateral plate). Although quadrilateral plate fractures are not formally considered as a separate parameter for the classification of acetabular fractures, due to the deep location and many important surrounding blood vessels and nerves, they have been considered as an important factor affecting surgical complexity.…”

Total hip arthroplasty vs. osteosynthesis in acute complex acetabular fractures in the elderly: Evaluation of surgical management and outcomes

“…As shown in the new study by Dettoni et al [29], the validation to adaptation of the Italian population to the HHS, HHS, and SF-12 is correlated with each other. A recent study by Tosounidis et al [30] shows that the quality of postoperative reduction was associated with HHS (P = 0.015) and postoperative arthritis (P = 0.010). A strong association was evident between age and postoperative reduction (P = 0.010) and arthritis (P = 0.014).…”

A short buttress plate fixation of posterior column through single ilioinguinal approach for complex acetabular fractures

“…Moreover, there is a risk of penetrating the joint [2]. In order to overcome this problem, several authors developed the new fixation strategies, including using a long infrapectineal buttress plate [3][4][5], or using a plate across the pelvic brim as spring plate to buttress the medial wall [6][7][8][9], or a novel quadrilateral surface buttress plate [10][11][12].…”