Supra-Pectineal QLS Plating Vs Infra-pectineal Plating in Management of Quadrilateral Plate Fractures

N/AActive Not RecruitingNCT06440590

Ain Shams University30 enrolled

Overview

The investigators conducted such a prospective randomized controlled study aiming to reach a satisfactory outcome and to compare supra-pectineal QL buttress plating versus infra-pectineal for management of anterior column with or without posterior hemi-transverse component and quadrilateral plate involvement.

Our hypothesis was that supra-pectineal quadrilateral buttress plating provides much more rigid fixation and a strong buttress for medial wall migration, also it could correlate with a better functional and radiological outcome. However, there is a lack of knowledge in the prospective assessment of functional and radiological outcomes and follow up of postoperative complications of supra-pectineal quadrilateral buttress plating versus infra-pectineal plating in fixation of QLS and to our knowledge, it will be the first study to include such measures of outcome together in a prospective randomized fashion.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Evaluation of QL Buttress Plating in QLP Fracture Fixation

Interventions

suprapectineal quadrilateral buttress platingPROCEDURE

15 cases will undergo anatomical supra-pectineal quadrilateral plate

Infra-pectineal platingPROCEDURE

15 cases will undergo conventional manually contoured infra-pectineal plate

Eligibility

Sex: ALLMin age: 16 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Anterior column fracture acetabulum with QLS involvement * Anterior column posterior hemi-transverse fracture acetabulum with QLS involvement * Age between 16-60 years' old Exclusion Criteria: * Open fractures * Associated pelvic ring injuries that require intervention * Associated internal organ injuries that require intervention * Age less than 14 years and older than 60 years

Locations (1)

Ain Shams university

Cairo, Abassia, Egypt

Outcomes

Primary Outcomes

Rate of Excellent, very good, Good, Average or Poor functional outcomes using Modified Merle d'Aubigné scoring system

Clinical assessment was done via Modified Merle d'Aubigné scoring system that was calculated at each follow-up visit (out of 18) and presented the mean value; the score evaluates three factors: pain, mobility \& ability to walk. the score maximum being 18 (excellent) and minimum 6 (poor)

Time frame: one-year post-operative

Rate of Anatomical, Congruent or Incongruent Radiological Outcomes using Matta & Tornetta radiological principles

Radiological assesment was done according to the grading of Matta and Tornetta, The investigators classified the results into: Anatomical, congruent \& incongruent; based on the restoration of the five anatomical lines (iliopectineal line, ilioischial line, acetabular dome, posterior wall \& anterior wall) \& best judged on the anteroposterior view.

Time frame: 1 year postoperative

Amount of residual displacement

Residual displacement was measured in millimeters and compared between the two study groups

Time frame: immediate post-operative and throughout study completion

Secondary Outcomes

post-operative complications' rate

The investigators focused the evaluation of Postoperative complications on the local complications related to fixation principles and technique: LLD, AVN of the hip joint, wound infection, residual malunion or non-union of the quadrilateral plate, and loss of reduction

Time frame: 1-year post-operative

Mean intraoperative blood loss

The mean blood loss was calculated and compared between the two study groups, it was measured intraoperative and postoperative from suction drains

Time frame: up to 4 days post-operative

Data from ClinicalTrials.gov

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