Infrapectineal plating for acetabular fractures: a technical adjunct to internal fixation

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Reconstruction

Background:

• Acetabular fractures with medial displacement, especially of the quadrilateral surface, present significant surgical challenges.
• Limited bone stock, restricted anatomical access, and difficulties in achieving stable internal fixation in the true pelvis complicate treatment.
• Existing methods may struggle to provide adequate stability for these complex fracture patterns.

Purpose of the Study:

• To introduce and evaluate a medial buttress plate technique as an adjunct for internal fixation in acetabular fractures with medial displacement.
• To demonstrate the feasibility and effectiveness of this technique in enhancing fixation stability.
• To address the specific challenges posed by medial displacement of the quadrilateral surface.

Main Methods:

• The technique involves applying an undercontoured medial buttress plate across the quadrilateral plate in the true pelvis.
• The approach utilizes a contralateral ilioinguinal or modified Stoppa approach.
• The plate is secured posteriorly along the sciatic buttress and anteriorly on the pubic ramus, resisting medial displacement.

Main Results:

• The medial buttress plate acts as a valuable adjunct to standard internal fixation.
• This technique effectively resists medial secondary redisplacement of fracture fragments.
• It contributes to achieving more stable fixation in complex acetabular fractures involving the quadrilateral plate.

Conclusions:

• The medial buttress plate technique offers a viable solution for surgically managing acetabular fractures with medial displacement patterns.
• This approach enhances fixation stability, particularly for fractures involving the quadrilateral plate.
• It represents a useful adjunct for orthopedic surgeons treating complex acetabular injuries.