Supra-pectineal quadrilateral buttress plating versus infra-pectineal plating in the management of quadrilateral plate fractures: A randomized controlled trial.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI:10.1007/s00264-024-06344-9

Islam Sayed Moussa, Amr Mohammed Nagy

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引用次数: 0

Abstract

Purpose: Management of quadrilateral plate fractures is technically demanding and requires specific fixation techniques. Infra-pectineal plating is the gold standard method of fixation. However, we recorded a high incidence of medial wall displacement and reoperations. Therefore, the aim of our study was to identify whether supra-pectineal quadrilateral buttress plating provides much more rigid fixation with a better functional and radiological outcome or not.

Patients and methods: The authors conducted this prospective, randomized control, single-blinded study at a level 1 single trauma centre. Between March 2022 and June 2023, 34 patients with quadrilateral plate fractures had anterior fixation, either via the anatomical QLP (17 cases) or infra-pectineal plating (17 cases) (Groups A and B, respectively). The radiological and clinical outcomes, as well as residual medial wall displacement, were the primary outcomes.

Results: The mean follow-up was 14.47 months in group A and 15.24 months in group B. In group A, the mean operative time (p = 0.02) was shorter, and the mean blood loss (p < 0.001) was significantly lower. However last follow-up showed no statistically significant differences as regards residual medial wall displacement (p = 1.0), final radiological (p = 0.86), and clinical outcomes (p = 1.0).

Conclusion: Authors concluded that the anatomical QLP made it easier to reduce and fix acetabular fractures with a displaced medial wall. This was done by using multidirectional screws in the posterior column through its infra-pectineal extension and a strong screw purchase aimed at the posterior column through its supra-pectineal part. The two groups were similar in terms of final radiological and clinical outcomes, as well as residual medial wall displacement rates. However, the QLP had less morbidity than the classic infra-pectineal plating (shorter operation time and less blood loss).

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在治疗四边形钢板骨折时，会阴上四边形对接钢板与会阴下钢板：随机对照试验。

目的：四边形钢板骨折的治疗对技术要求很高，需要特殊的固定技术。腹股沟下钢板固定是固定的金标准方法。然而，我们发现内侧壁移位和再次手术的发生率很高。因此，我们的研究目的是确定会阴上四边形支撑钢板是否能提供更坚硬的固定，以及是否能获得更好的功能和放射学结果：作者在一家一级单体创伤中心开展了这项前瞻性、随机对照、单盲研究。在 2022 年 3 月至 2023 年 6 月期间，34 名四边形钢板骨折患者接受了前路固定，固定方式为解剖型 QLP（17 例）或pectineal 下钢板固定（17 例）（分别为 A 组和 B 组）。放射学和临床结果以及残余内侧壁移位是主要结果：A 组的平均随访时间为 14.47 个月，B 组为 15.24 个月：作者得出结论：解剖学 QLP 使内侧壁移位的髋臼骨折更容易缩小和固定。这是通过在后柱中使用多向螺钉穿过其下胸骨延长线，并通过其上胸骨部分对准后柱进行强力螺钉置入来实现的。就最终的放射学和临床结果以及残余内侧壁移位率而言，两组患者的情况相似。不过，QLP的发病率低于传统的会阴下钢板植入术（手术时间更短，失血量更少）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.