Quadrilateral Plate Fractures of the Acetabulum: Proposition for a Novel Classification System

Publication date: Available online 1 December 2017
Source:Injury
Author(s): Walid A ElNahal, Mahmoud Abdel Karim, Sherif A. Khaled, Ahmed Hazem Abdelazeem, Hazem Abdelazeem
BackgroundCurrently, there is no definition or classification system for quadrilateral plate (QLP) fractures; the aim was to anatomically and radiologically characterise the QLP, propose a definition and classify QLP fractures.MethodsThis study included an anatomical component and a radiological component. The anatomical study aimed at defining the characteristics of the QLP; the QLP was identified using four articulating bony pelvis specimens. A titanium mesh was placed on the specimens' quadrilateral surface; standard anteroposterior and oblique views were obtained, and axial CT images, to determine the radiological landmarks. The radiological study included the review of images of patients with QLP fractures; fractures involving the QLP were identified in a series of 609 consecutive patients with acetabular fractures.ResultsWe considered QLP fractures where the QLP is separated from both columns of the acetabulum; this was found in 16% (98 cases). They were mostly encountered with associated both columns fractures (60 cases; 61%), Separation of the QLP could be complete or incomplete, or simple or comminuted, so QLP fractures were divided into three types: QLP1, simple with incomplete separation; QLP2, comminuted with incomplete separation; QLP3, comminuted with complete separation (QLP4), simple with complete separation.ConclusionThe QLP was characterised, and a definition and classification system was proposed for these fractures. We believe that this classification may prove useful in the future for the identification and management of these fractures.



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