Imaging Acetabular Fractures.

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Abstract

[Indexed for MEDLINE] 3. Arch Orthop Trauma Surg. 2024 Dec 16;145(1):51. doi: 10.1007/s00402-024-05698-4. Quadrilateral plate fractures. Freude T(1), Gänsslen A(2)(3), Krappinger D(4), Lindahl J(5). Author information: (1)University Hospital for Orthopaedics and Traumatology, Müllner Hauptstraße 48, Salzburg, A-5020, Austria. (2)Department of Trauma Surgery, Hannover Medical School, Hannover, Germany. dr.gaensslen@gmx.de. (3)Department of Trauma and Orthopedics, Johannes Wesling Hospital, Minden, Germany. dr.gaensslen@gmx.de. (4)Department of Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, Innsbruck, A-6020, Austria. (5)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. QLP fracture features include simple fracture lines up to highly comminuted fractures. A detailed preoperative analysis of these fractures is important to get a better understanding of intraoperative decision making. No consensus exists regarding the optimal classification and treatment of QLP fractures. Various operative approaches and treatment concepts exists depending on the specific QLP fracture type and the acetabular fracture type. Several new implants were development for optimal but often individual stabilization concepts. The gold-standard is still some medial buttressing during internal fixation predominantly using plates, but also screw fixation is considered an option. Additional dome impactions must be considered as an integral part in any QLP fracture analysis and stabilization. © 2024. The Author(s). DOI: 10.1007/s00402-024-05698-4 PMCID: PMC11649797