Is the Direct Fixation of Displaced Quadrilateral Plates in Acetabular Fractures Necessary?

Authors

Beom-Soo Kim
Ki-Cheor Bae
Chul-Hyun Cho
Kyung-Jae Lee
In Gyu Lee
Min-Gyu Lee
Byung-Woo Min

Publication Date

11-9-2023

Journal

Journal of Clinical Medicine

Abstract

Quadrilateral plate fractures represent a heterogeneous group of acetabular fractures. Accurate reduction is required to prevent post-traumatic arthritis. The purpose of this study is to determine the reduction effect of the direct fixation of quadrilateral plates in acetabular fractures, and to evaluate the strength of direct fixation compared to indirect fixation. Between 2005 and 2021, 49 patients underwent surgery for open reduction and internal fixation in acetabular fractures with severely displaced quadrilateral plates. Twenty-nine patients comprised the indirect fixation group, and twenty patients comprised the direct fixation group. In a comparison of primary outcome between two groups, 10 out of 29 indirect-group patients and 1 out of 20 direct-group patients developed post-traumatic osteoarthritis, wherein the difference between the two groups is statistically significant. In the assessment of postoperative Matta's radiological reduction status, 19 out of 20 patients in the direct group had achieved anatomical and congruent reduction. The treatment using a direct reduction and internal fixation improved the reduction quality of articular displacement and offered a better survivorship of the affected hip joint.

Keywords

acetabular fractures, quadrilateral plate, treatments, fixation, outcomes

Comments

Data Availability Statement

PMID: 38002609