Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Fractures involving both columns of the acetabulum are challenging particularly those with quadrilateral plate (QLP) involvement, as it adds on more burden to anatomical reconstruction and fixation. Additionally we are seeing more comminuted and osteoporotic acetabular fractures due to the rise in the numbers of elderly population. A variety of implants have been developed to address the problem of displaced quadrilateral plate fractures recently, including anterior intrapelvic approach (AIP) specific instruments and anatomic suprapectineal quadrilateral surface plating system (QLS) yet with limited published evidence. This study suggested that using novel approach specific instruments and anatomical pre-shaped plates through anterior intra-pelvic approach, has led to anatomical reduction in 82% of the cases on post-operative CT scans with 69% excellent and very good functional outcome at 1 year follow up, and a low complication rate. Older age was associated with poorer radiological and functional outcomes. Larger scale randomised control studies with longer term follow up are recommended to establish the effectiveness of these plates against the conventional ones

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