Objective

To investigate whether the fracture morphology of quadrilateral plate (QP) fragments is associated with the anterior and posterior columns in associated both-column (ABC) fractures.

Materials and methods

Three-dimensional computed tomography data of 100 ABC fractures treated at our hospital from August 2016 to August 2019 were retrospectively analyzed using Mimics and 3-matic software. The distribution of fracture lines was described using the fracture mapping technique.

Results

One fragment presented on the QP was confirmed in 88% of the patients. The QP fragments’ fracture lines were divided into the anterior oblique (AO), superior posterior oblique (SPO), and mid-posterior oblique (MPO) lines, occurring in 100, 86, and 8 cases, respectively. AO lines were distributed along the arcuate line. SPO lines were continuations of the AO lines, which were distributed to the posterior column from the greater sciatic notch to the lesser sciatic notch. MPO lines were involved in the QP’s central area. A simple fracture was found at the proximal AO and SPO lines in 80% and 86% of all displaced fractures, respectively. AO lines distal to the superior rim of the acetabula were confirmed to be comminuted fractures in 32% of all cases.

Conclusions

In ABC fractures, there was only one QP fragment in nearly 90% of all cases. The QP fractures were mainly present in the QP’s peripheral area. More than 80% of the fracture patterns on the cephalic side of the QP were simple. The reduction and internal fixation of QP fractures in ABC fractures should be in the cephalic region.

中文翻译：

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相关双柱髋臼骨折四边形钢板碎片三维形态学分析

客观的

探讨四边形钢板（QP）碎片的骨折形态是否与相关双柱（ABC）骨折的前柱和后柱有关。

材料和方法

采用 Mimics 和 3-matic 软件对我院 2016 年 8 月至 2019 年 8 月收治的 100 例 ABC 骨折的三维 CT 数据进行回顾性分析。使用断裂映射技术描述断裂线的分布。

结果

88% 的患者确认了 QP 上出现的一个片段。QP碎片骨折线分为前斜线（AO）、上后斜线（SPO）和中后斜线（MPO），分别发生100、86和8例。AO线沿弓形线分布。SPO线是AO线的延续，从坐骨大切迹到坐骨小切迹分布到后柱。QP 的中心区域涉及 MPO 线路。在所有移位骨折中，分别有 80% 和 86% 在近端 AO 和 SPO 线发现简单骨折。在所有病例中，32% 的髋臼上缘远端的 AO 线被证实为粉碎性骨折。

结论

在 ABC 骨折中，近 90% 的病例中只有一个 QP 碎片。QP骨折主要存在于QP的周边区域。超过 80% 的 QP 头侧骨折模式是简单的。ABC骨折中QP骨折的复位内固定应在头侧。