Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures

Quadrilateral plate acetabular fractures are complex injuries that present challenges in achieving stable fixation due to their anatomical location and high risk of medial displacement. The direct infrapectineal plate, applied via the ilioinguinal approach, offers a biomechanically stable construct for buttressing the medial acetabular wall.

This prospective cohort study enrolled 25 patients aged 18-64 years with acute quadrilateral plate acetabular fractures between January 2021 and January 2024. Patients with pathological fractures, pre-existing ipsilateral hip disease, or delayed presentation (>4 weeks) were excluded.

The surgical procedure involved direct infrapectineal plating through the ilioinguinal approach. Radiological outcomes were measured using the Matta scoring system, and functional results were assessed with the Merle d'Aubigné and Postel scoring system at a mean follow-up of 14.7 months. Secondary measures included operative time, blood loss, hospital stay, and complication profile.

Preliminary results showed that anatomical reduction was achieved in 64% of patients, with excellent or good functional results in 68%. The complication rate was low, with only one case of deep infection requiring implant removal.

The study concludes that infrapectineal plating provides stable fixation with favorable functional and radiological outcomes for quadrilateral plate acetabular fractures.

Inclusion criteria

Adults aged 18-64 years.

Acute quadrilateral plate acetabular fractures (≤3 weeks from injury).

Medically fit for surgery under general or regional anesthesia.

Patients willing to participate and provide informed consent. -

Exclusion criteria

Pathological fractures (e.g., metastatic or metabolic).

Pre-existing ipsilateral hip pathology affecting radiological or functional outcomes.

Delayed presentation: injury >4 weeks before surgery.

Medical contraindications to surgery (e.g., unstable comorbidities).

Polytrauma patients with hemodynamic instability.

-