A new classification for quadrilateral plate fracture of acetabulum

作者全名："Chen, Kaifang; Yao, Sheng; Yin, Yingchao; Wan, Yizhou; Ahn, Jaimo; Zhu, Shiwen; Chen, Hua; Fan, Shicai; Guo, Shuquan; Yi, Chengla; Li, Lianxin; Hou, Zhiyong; Guo, Xiaodong"

作者地址："[Chen, Kaifang; Yao, Sheng; Wan, Yizhou; Guo, Xiaodong] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Orthopaed, Wuhan, Peoples R China; [Yao, Sheng] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Rehabil Med, Wuhan, Peoples R China; [Yin, Yingchao; Hou, Zhiyong] Hebei Med Univ, Hosp 3, Dept Orthopaed Surg, Shijiazhuang, Peoples R China; [Ahn, Jaimo] Univ Michigan, Dept Orthopaed Surg, Michigan Med, Ann Arbor, MI USA; [Zhu, Shiwen] Beijing Jishuitan Hosp, Dept Orthoped & Traumatol, Beijing, Peoples R China; [Chen, Hua] Gen Hosp Chinese Peoples Liberat Army, Dept Orthopaed Surg, Beijing, Peoples R China; [Fan, Shicai] Southern Med Univ, Affiliated Hosp 3, Dept Orthopaed, Guangzhou, Peoples R China; [Guo, Shuquan] Chongqing Med Univ, Affiliated Hosp 1, Dept Orthopaed, Chongqing, Peoples R China; [Yi, Chengla] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Trauma Surg, Wuhan, Peoples R China; [Li, Lianxin] Shandong Univ, Shandong Prov Hosp, Dept Orthopaed, Jinan, Peoples R China"

通信作者："Guo, XD (通讯作者)，Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Orthopaed, Wuhan, Peoples R China.; Hou, ZY (通讯作者)，Hebei Med Univ, Hosp 3, Dept Orthopaed Surg, Shijiazhuang, Peoples R China."

来源：INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001016868100001

JCR分区：Q2

影响因子：2.2

年份：2023

卷号：54

期号：7

开始页：　

结束页：　

文献类型：Article

关键词：Acetabulum; Quadrilateral plate; Classification; Buttressing fixation

摘要："Background: Recently, quadrilateral plate (QLP) fractures of acetabulum have attracted increasing attention. However, evidence for the appropriate classification of QLP fractures is still lacking, making it difficult to understand and manage these fractures. This study aimed to introduce a new classification for QLP fractures and evaluate its reproducibility.Methods: A series of 1101 consecutive patients with acetabular fractures from 8 level-I trauma centers were enrolled in this study. All patients underwent preoperative radiograph and computed tomography imaging. QLP fractures were identified and classified using the new and Judet-Letournel classification system. The inter- and intra-observer reliabilities (kappa coefficients, & kappa;) of these two systems were investigated by 4 observers. Furthermore, surgical approaches and fixation methods for each fracture type are described.Results: In total, 243 (243/1101, 22%) patients with QLP fractures were identified and included in this analysis. The mean & kappa; value of the intra-observer reliability was 0.84 (range, 0.763-0.919) for the new classification, indicating excellent agreement, and the inter-observer reliability was 0.762 (range, 0.625-0.876), indicating substantial agreement. The values were 0.649 (range, 0.523-0.708) and 0.584 (0.497-0.646), respectively, according to the Judet-Letournel classification. Six cases (6/243, 2.5%) could not be classified using the JudetLetournel classification. The selection of surgical approaches and fixation methods depends on the fracture type; however, an anterior intra-pelvic approach and buttressing fixation using the plate or screw are preferred for QLP fractures.Conclusion: This study presents a new classification for QLP fractures, showing higher intra- and inter-observer reliabilities than those obtained using the Judet-Letournel classification. This allowed us to obtain an in-depth and comprehensive understanding of QLP fractures. Additionally, the new classification might guide further studies on surgical strategies for QLP fractures.Level of Evidence: Level II"

基金机构："National Natural Science Foundation of China [82202715, 82072446, 81873999]"

基金资助正文："National Natural Science Foundation of China (grant no. 82202715, 82072446 and 81873999)"