Quadrilatral plate stabilization: Conventional reconstruction plate or anatomical plate: A systematic review and...

Quadrilateral plate fractures are a persistent challenge to orthopedic surgeons. The last decade has seen the development of novel anatomical plates for fixation of these fractures but they haven't been widely adopted. The aim of this study was to study the literature published on plate fixation of quadrilateral plate fractures and analyse the differences between the time-tested reconstruction plate and anatomical plate.

PRIMSA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed and the search was performed on 3 databases - PubMed, SCOPUS, and EMBASE. The study was registered with PROSPERO (International Prospective Register of Systematic Reviews) under the registration number CRD420251017775. 12 studies of which 4 were comparative were chosen after thorough screening and a meta-analysis was performed between reconstruction plates and anatomical plates to study the intra-operative and post-operative results. The studies were conducted between 2007 and 2021.

583 patients with an average age of 55.45 years of which 75.8 % were males were studied. Intraoperatively, surgical time and blood loss were found to be significantly less in the anatomical plate group versus the reconstruction plate group. Quality of reduction as per Matta's criteria and long term outcomes reported as per Merle's score were found to be similar in both the groups. The rate of complications was higher in the reconstruction plate group.

The anatomical plate is better for fixation of quadrilateral plate fractures in terms of intraoperative blood loss and operative time. However, the long term outcomes are equivocal.