Isolated quadrilateral plate fractures are extremely rare and their treatment is complex. The postpartum period and recent caesarean section additionally increase already significant risks of surgical treatment. Modified Stoppa approach and the use of infrapectineal plate represent the optimal surgical treatment method. One case of central hip dislocation and isolated quadrilateral plate fracture was reported during an epileptic seizure 1 day postpartum, which was treated with open reduction and internal fixation. A 25-year-old female patient had given birth via cesarean section. One day postpartum, she had multiple generalized tonic clonic seizures. Arteriovenous malformation was identified as the cause of seizures by MRI. The patient complained of left hip pain and inability to move the left leg which prompted clinical and radiological examination. A pelvic CT scan verified multifragmentary fracture of the quadrilateral plate without fracture of the acetabular columns. The central hip dislocation was verified. Due to the rarity of the fracture, the clinical decision-making process was difficult. The patient, being in the postpartum period, was also at a greater risk of infection. The patient was treated surgically, and osteosynthesis was performed with an infrapectineal plate for the acetabulum using the modified Stoppa approach. The initial incision was done through the same Pfannenstiel incision from caesarean section. The patient's postoperative recovery was good at 1 year follow-up.
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http://dx.doi.org/10.1016/j.cjtee.2023.06.006 | DOI Listing |
Sci Rep
January 2025
Department of Orthopaedic, South China Hospital of Shenzhen University, Shenzhen, 518116, Guangdong, China.
Before patients begin out-of-bed exercises following internal fixation surgery for acetabular fractures, turning over in bed serves as a crucial intervention to mitigate complications associated with prolonged bed rest. However, data on the safety of this maneuver post-surgery are limited, and the biomechanical evidence remains unclear. This study aims to introduce a novel loading protocol designed to preliminarily simulate the action of turning over in bed and to compare the biomechanical properties of two fixation methods for acetabular fractures under this new protocol.
View Article and Find Full Text PDFCureus
November 2024
Orthopaedic Department, Thriasio General Hospital, Athens, GRC.
The quadrilateral surface fractures of the acetabulum are becoming more frequent due to the aging population. The optimal fixation of the quadrilateral surface through an appropriate surgical approach and a reliable and effective technique presents a challenge for orthopedic trauma surgeons. In this study, we present the results of 12 patients treated in our department who underwent internal fixation of the quadrilateral surface with two reconstruction plates in a vertical orientation for adequate fracture buttressing.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
The today well accepted intrapelvic approach for acetabular and pelvic ring injury fixation was first described by Hirvensalo and Lindahl in 1993 followed by a more detailed description by Cole and Bolhofner in 1994. Compared to the well-known ilioinguinal approach, described by Letournel, this approach allows an intrapelvic view to the medial acetabulum, while using the ilioinguinal approach a more superior, extrapelvic view, is dissected to the area of the acetabulum. Several names have been used to describe the new intrapelvic approach with increasing usage, mainly ilio-anterior approach, extended Pfannenstiel approach, Stoppa-approach, Rives-Stoppa approach, modified Stoppa approach and recently anterior intrapelvic approach.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Orthopaedics, Wuhan General Hospital, Wuhan, Hubei Province, China.
Quadrilateral plate fracture is one of the most complex and challenging pelvic lesions. Operative reduction and internal fixation are the gold standard management for displaced quadrilateral plate fractures. Traditional methods include various kinds of operative reduction and internal fixation through either anterior or posterior approaches using various combinations of plates and lag screws or acute total hip arthroplasty.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopaedics and Traumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
During the last two decades, extended scientific interest focused on quadrilateral plate (QLP) fractures as part of common acetabular fractures. The QLP corresponds to the medial wall of the acetabulum, and different fracture pattern of Letournel´s fracture types are associated with concomitant QLP fractures. Except anterior and posterior wall fractures, all other fracture types may be associated with QLP fractures.
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