A 3D CT morphometric analysis of the medial pelvic terrain: New insights into quadrilateral plate and medial acetabular surface

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-03-17 DOI:10.1016/j.jcot.2025.102978

Abhay Elhence, Ashraf Jamal, Sandeep Kumar Yadav

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引用次数: 0

Abstract

Background

The medial bony hemipelvis has been defined as quadrilateral plate (QP). Any isolated or combined injuries to QP, often lead to early degenerative arthritis of hip joint. Conventionally defined QP and its delineation of fixation zones from non-fixation zone or medial acetabular surface (MAS) will lead to novel Pentagonal Plate (PP).

Methodology

3D reconstructions of the pelvic CT scans were created, focusing on right hemipelvis for all patients. The dimensions of the QP and novel PP in the right hemipelvis were defined and measured using RadiAnt DICOM Viewer software. Statistical analysis was conducted using latest version of SPSS software.

Results

This study included 100 adults (42 females and 58 males) who underwent CT scans of pelvis for non traumatic non orthopedic reasons like gynaecological, general surgical and urological reasons between July 2019 and December 2020. Average dimensions of the sides of conventional QP were found to be 4.95 ± 0.85 cm, 3.98 ± 0.73 cm, 4.03 ± 0.78 cm, and 5.48 ± 0.91 cm. The study identifies 3 triangular fixation zones within conventional QP, corresponding to the sciatic buttress, part of anterior column, and part of the posterior column. These zones were excluded from conventional QP, resulting in definition of a novel pentagonal plate (PP) with a 34 % smaller surface area, precisely delineating true medial surface of acetabular socket.

Conclusion

Novel PP identifies MAS with more precision and delineates 3 triangular fixation zones across sciatic buttress, anterior and posterior columns. This knowledge enables better understanding of fixation zones and force concentration due to antecedent injury which opens doors to newer plate designs, explaining why certain fractures involving the MAS undergo early degenerative arthritis and rationalizing alternative treatment strategies like fix and replace for even younger patients with adverse fracture configurations.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.