Related Experiment Video
Updated: Jul 19, 2026
Use of a Wireless Video-EEG System to Monitor Epileptiform Discharges Following Lateral Fluid-Percussion Induced Traumatic Brain Injury
Published on: June 21, 2019
Isolated quadrilateral plate fracture with central hip dislocation after epileptic seizure in a postpartum patient: A
Jana Gulija1, Tomislav Žigman2, Ivan Dobrić2
1School of Medicine, University of Zagreb, Zagreb, 10000, Croatia.
Insights
This case study details treating a rare quadrilateral plate fracture with hip dislocation in a postpartum patient. The modified Stoppa approach with an infrapectineal plate proved effective for this complex fracture.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Obstetrics
Background:
- Isolated quadrilateral plate fractures are rare and challenging to treat.
- Postpartum patients, especially after cesarean section, face increased surgical risks.
Observation:
- A postpartum patient experienced seizures due to arteriovenous malformation, leading to central hip dislocation and an isolated quadrilateral plate fracture.
- Diagnosis was confirmed via pelvic CT scan, revealing a multifragmentary fracture without acetabular column involvement.
Findings:
- Surgical treatment involved open reduction and internal fixation using a modified Stoppa approach and an infrapectineal plate.
- The surgical incision utilized the existing Pfannenstiel incision from the cesarean section.
Implications:
- This case highlights the modified Stoppa approach and infrapectineal plate as optimal for managing complex quadrilateral plate fractures.
- The successful outcome demonstrates effective surgical management even in high-risk postpartum patients.
Abstract:
Isolated quadrilateral plate fractures are extremely rare and their treatment is complex. The postpartum period and recent caesarean section additionally increase already significant risks of surgical treatment. Modified Stoppa approach and the use of infrapectineal plate represent the optimal surgical treatment method. One case of central hip dislocation and isolated quadrilateral plate fracture was reported during an epileptic seizure 1 day postpartum, which was treated with open reduction and internal fixation. A 25-year-old female patient had given birth via cesarean section. One day postpartum, she had multiple generalized tonic clonic seizures. Arteriovenous malformation was identified as the cause of seizures by MRI. The patient complained of left hip pain and inability to move the left leg which prompted clinical and radiological examination. A pelvic CT scan verified multifragmentary fracture of the quadrilateral plate without fracture of the acetabular columns. The central hip dislocation was verified. Due to the rarity of the fracture, the clinical decision-making process was difficult. The patient, being in the postpartum period, was also at a greater risk of infection. The patient was treated surgically, and osteosynthesis was performed with an infrapectineal plate for the acetabulum using the modified Stoppa approach. The initial incision was done through the same Pfannenstiel incision from caesarean section. The patient's postoperative recovery was good at 1 year follow-up.
