Abstract
BackgroundQuadrilateral plate fractures are a challenging group of acetabular fractures to manage. However, there is little literature that describes the fracture lines of the quadrilateral plate. The aim of this study was to explore the fracture lines of the quadrilateral plate and relevant clinical significance.MethodsCT data from a series of acetabular fractures were retrospectively analyzed. According to the X-ray, CT, and operative records of the patients, Judet-Letournel classification was carried out for acetabular fractures involving quadrilateral plate. Then, the fracture maps of different types of acetabular fractures in the quadrilateral plate were drawn. To facilitate the characterization of fracture maps, we defined six basic fracture lines.ResultsThe fracture lines of the three types of acetabular fractures (double-column fracture, T-type fracture, and anterior column with posterior hemitransverse fracture) mainly included upper transverse lines and upper oblique lines. Although the fracture lines of posterior wall fracture and anterior column fracture were mainly upper transverse lines, the fracture lines of the former were in a low position. The fracture lines of transverse fracture and transverse with posterior wall fracture were similar, both of which were mainly upper oblique lines. The fracture lines of posterior column fractures mainly included posterior vertical lines.ConclusionsThe fracture lines of different types of acetabular fractures have certain regularity respectively. Observation of the fracture lines of the quadrilateral plate based on fracture mapping can help orthopedic surgeons to enhance the understanding of the Judet-Letournel classification, which may have some significant guidance on the choice of operation approach and the design of internal fixation devices.
Highlights
Quadrilateral plate fractures are a challenging group of acetabular fractures to manage
Acetabular fractures involving the quadrilateral plate were classified according to Judet-Letournel classification, which consisted of 59 cases of double-column fracture, 43 cases of transverse with posterior wall fracture, 36 cases of T-type fracture, 26 cases of transverse fracture, 20 cases of anterior column with posterior hemitransverse fracture, 12 cases of posterior column with posterior wall fracture, 9 cases of anterior
Men Women Side of injury, n (%) Right Left Bilateral Treatment, n (%) Operative Conservative Mechanism of injury, n (%) Motor vehicle collision Fall from height Others All patients, n Letournel classification, n (%) Double-column Transverse with posterior wall T-type Transverse Anterior column with posterior hemitransverse Posterior column with posterior wall Anterior column Posterior column All fractures, n column fracture, and 6 cases of posterior column posterior column fractures were in the infero-posterior fracture (Table 1)
Summary
Quadrilateral plate fractures are a challenging group of acetabular fractures to manage. There is little literature that describes the fracture lines of the quadrilateral plate. The aim of this study was to explore the fracture lines of the quadrilateral plate and relevant clinical significance. Clinical outcomes were correlated with variables including fracture type, the accuracy of reduction, and patient age [3,4,5,6]. The most clinically used classification is the Judet-Letournel classification [7, 8], which is based on the column theory and describes fracture anatomy in relation to the anterior and posterior columns. The accuracy of reduction is closely related to the choice of surgical approach. No single approach can meet the needs of all acetabular fracture types. The choice of surgical approach depends on multiple factors, including the fracture pattern, familiarity with complex
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