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.

Abstract Image

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骨盆内侧地形的三维CT形态分析：四边形钢板和髋臼内侧表面的新见解

背景：内侧骨半骨盆被定义为四边形钢板（QP）。QP的任何单独或合并损伤，常导致早期髋关节退行性关节炎。传统定义的QP及其从非固定区或髋臼内侧面（MAS）划定的固定区将导致新的五边形钢板（PP）。方法：对所有患者的骨盆CT扫描进行三维重建，重点是右半骨盆。使用RadiAnt DICOM Viewer软件定义和测量右半骨盆QP和新PP的尺寸。采用最新版SPSS软件进行统计分析。该研究包括100名成年人（42名女性和58名男性），他们在2019年7月至2020年12月期间因妇科、普外科和泌尿外科等非创伤性非矫形原因接受了骨盆CT扫描。常规QP的平均侧面尺寸分别为4.95±0.85 cm、3.98±0.73 cm、4.03±0.78 cm和5.48±0.91 cm。本研究在常规QP内确定了3个三角形固定区，分别对应坐骨支撑、部分前柱和部分后柱。这些区域被排除在传统的QP之外，从而定义了一个新的五边形钢板（PP），其表面积缩小了34%，准确地描绘了髋臼臼的真正内侧表面。结论新型PP能更准确地识别MAS，并能在坐骨支撑、前后柱上划分出3个三角形固定区。这些知识可以更好地理解由于先前损伤导致的固定区域和力集中，从而为新的钢板设计打开了大门，解释了为什么某些涉及MAS的骨折会发生早期退行性关节炎，并为具有不良骨折结构的年轻患者提供了合理的替代治疗策略，如固定和置换。

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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.