Intrapelvic suprapectineal acetabular plates interfere with the quality of reduction evaluations on postoperative X-rays. A retrospective case series.

Abstract

Introduction: Intrapelvic suprapectineal plates play an important role in acetabular fracture fixation. However, the shape of these implants may interfere with the quality of reduction evaluations using plain X-rays. We sought to evaluate this artifact and its relationship with CT findings.

Materials and methods: In a retrospective, single-center series of 22 acetabular fractures, postoperative AP, alar and obturator X-ray views and CT images were evaluated by three independent observers. Cohen's kappa was used to examine interrater reliability.

Results: Suprapectineal plates interfered with the evaluation of the weight-bearing surface in 75.3%, and with all three oblique views in 43.9% of cases. The central segment was most consistently interfered with, corresponding to the area where the greatest malreduction was in 46.9% coronal and 42.4% of sagittal CT views.

Conclusions: Since the quality of reduction has prognostic value and is a necessary guide for the surgical team, that CT may be considered for the postoperative examination of the most challenging acetabular fracture cases.