A study on fracture lines of the quadrilateral plate based on fracture mapping

Abstract

Background Quadrilateral 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. Methods CT 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. Results The 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. Conclusions The 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.

Morphological Characteristics of the Posterior Wall Associated with Complex Acetabular Fractures: A Radiological Study Using 3D Software and Fracture Mapping Technique

“…In addition, this technique was widely used in the acetabulum. Yang et al [ 12 , 13 ] established a frequency map of acetabular both-column fractures and quadrilateral fractures to help surgeons gain insights into the surgery. Cho et al [ 14 ] evaluated the characteristics of isolated PW fractures of the acetabulum with a cohort of 51 patients to show fracture patterns and recurrent fracture zones.…”

Fracture mapping of complex intra-articular calcaneal fractures

“…Fracture mapping can record the size, shapes, numbers, and orientations of fracture fragments, and help surgeons determine the optimal treatment (5). To date, fracture mapping has been applied to scapular, tibial, hip, and acetabular fractures (6)(7)(8)(9)(10)(11). However, there have been no reports concerning fracture mapping for the treatment of calcaneal fractures.…”

The novel infra‐pectineal buttress plates used for internal fixation of elderly quadrilateral surface involved acetabular fractures

“…Yang et al . 27 identified the borders of the quadrilateral plate, which was same as ElNahal et al ., and described a fracture map of QLS. Guyton and Perez 28 considered QLS to be the medial wall of acetabulum, and mentioned that it was located near the femoral head limiting the options for its fixation.…”

“…ElNahal, et al 23 considered it as the trapezoidal area and described that the QLS extended from the pelvic brim superiorly to a line joining the ischial spine and obturator foramen inferiorly, and is bound by the greater sciatic notch posteriorly and the obturator foramen anteriorly. Yang et al 27 identified the borders of the quadrilateral plate, which was same as ElNahal et al, and described a fracture map of QLS. Guyton and Perez 28 considered QLS to be the medial wall of acetabulum, and mentioned that it was located near the femoral head limiting the options for its fixation.…”