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Three-dimensional morphological analysis of quadrilateral plate fragments in associated both-column acetabular fractures

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Abstract

Objective

To investigate whether the fracture morphology of quadrilateral plate (QP) fragments is associated with the anterior and posterior columns in associated both-column (ABC) fractures.

Materials and methods

Three-dimensional computed tomography data of 100 ABC fractures treated at our hospital from August 2016 to August 2019 were retrospectively analyzed using Mimics and 3-matic software. The distribution of fracture lines was described using the fracture mapping technique.

Results

One fragment presented on the QP was confirmed in 88% of the patients. The QP fragments’ fracture lines were divided into the anterior oblique (AO), superior posterior oblique (SPO), and mid-posterior oblique (MPO) lines, occurring in 100, 86, and 8 cases, respectively. AO lines were distributed along the arcuate line. SPO lines were continuations of the AO lines, which were distributed to the posterior column from the greater sciatic notch to the lesser sciatic notch. MPO lines were involved in the QP’s central area. A simple fracture was found at the proximal AO and SPO lines in 80% and 86% of all displaced fractures, respectively. AO lines distal to the superior rim of the acetabula were confirmed to be comminuted fractures in 32% of all cases.

Conclusions

In ABC fractures, there was only one QP fragment in nearly 90% of all cases. The QP fractures were mainly present in the QP’s peripheral area. More than 80% of the fracture patterns on the cephalic side of the QP were simple. The reduction and internal fixation of QP fractures in ABC fractures should be in the cephalic region.

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Author notes

  1. Kai Ye and Jianfei Tang contributed equally to this work.

Authors and Affiliations

  1. Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, NO.600 Yishan Road, Shanghai, 200233, China

    Kai Ye, Jianfei Tang, Longxiang Shen & Zhiquan An

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  1. Kai Ye
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  2. Jianfei Tang
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  3. Longxiang Shen
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  4. Zhiquan An
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Corresponding author

Correspondence to Zhiquan An.

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This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was granted by the review board of our institution.

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The requirement for obtaining patient informed consent was waived by the ethics review board.

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The authors declare no competing interests.

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Ye, K., Tang, J., Shen, L. et al. Three-dimensional morphological analysis of quadrilateral plate fragments in associated both-column acetabular fractures. Skeletal Radiol 51, 2175–2184 (2022). https://doi.org/10.1007/s00256-022-04068-8

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  • DOI: https://doi.org/10.1007/s00256-022-04068-8

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