Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures (Infrapectineal)

Radiological and Functional Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study

This study aims to evaluate the outcomes of direct infrapectineal plate fixation in patients with quadrilateral plate acetabular fractures. A total of 25 adult patients with acute fractures were enrolled between 2021 and 2024 at a university-affiliated hospital. All patients underwent surgical fixation through the ilioinguinal approach. Radiological results were assessed using the Matta scoring system, and functional outcomes were evaluated using the Merle d'Aubigné and Postel scoring system. The study further assessed complication rates, operative time, intraoperative blood loss, and hospital stay.

Study Overview

• Status: Completed
• Conditions: Trauma (Including Fractures)
• Intervention / Treatment: Procedure: Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study

Detailed Description

Quadrilateral plate acetabular fractures are complex injuries that present challenges in achieving stable fixation due to their anatomical location and high risk of medial displacement. The direct infrapectineal plate, applied via the ilioinguinal approach, offers a biomechanically stable construct for buttressing the medial acetabular wall.

This prospective cohort study enrolled 25 patients aged 18-64 years with acute quadrilateral plate acetabular fractures between January 2021 and January 2024. Patients with pathological fractures, pre-existing ipsilateral hip disease, or delayed presentation (>4 weeks) were excluded.

The surgical procedure involved direct infrapectineal plating through the ilioinguinal approach. Radiological outcomes were measured using the Matta scoring system, and functional results were assessed with the Merle d'Aubigné and Postel scoring system at a mean follow-up of 14.7 months. Secondary measures included operative time, blood loss, hospital stay, and complication profile.

Preliminary results showed that anatomical reduction was achieved in 64% of patients, with excellent or good functional results in 68%. The complication rate was low, with only one case of deep infection requiring implant removal.

The study concludes that infrapectineal plating provides stable fixation with favorable functional and radiological outcomes for quadrilateral plate acetabular fractures.

• Study Type: Interventional
• Enrollment (Actual): 25
• Phase: Phase 4

Contacts and Locations

Study Locations

• Egypt
  • Cairo Governorate
    • Cairo, Cairo Governorate, Egypt, 11562
      • Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:Adults aged 18-64 years.

Acute quadrilateral plate acetabular fractures (≤3 weeks from injury).

Medically fit for surgery under general or regional anesthesia.

Patients willing to participate and provide informed consent. -

Exclusion Criteria:Pathological fractures (e.g., metastatic or metabolic).

Pre-existing ipsilateral hip pathology affecting radiological or functional outcomes.

Delayed presentation: injury >4 weeks before surgery.

Medical contraindications to surgery (e.g., unstable comorbidities).

Polytrauma patients with hemodynamic instability.

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Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Radiological and Functional Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Aceta; Quadrilateral plate acetabular fractures are complex injuries that present challenges in achieving stable fixation due to their anatomical location and high risk of medial displacement. The direct infrapectineal plate, applied via the ilioinguinal approach, offers a biomechanically stable construct for buttressing the medial acetabular wall. This prospective cohort study enrolled 25 patients aged 18-64 years with acute quadrilateral plate acetabular fractures between January 2021 and January 2024. Patients with pathological fractures, pre-existing ipsilateral hip disease, or delayed presentation (>4 weeks) were excluded. The surgical procedure involved direct infrapectineal plating through the ilioinguinal approach. Radiological outcomes were measured using the Matta scoring system, and functional results were assessed with the Merle d'Aubigné and Postel scoring system at a mean follow-up of 14.7 months. Secondary measures included operative time, blood loss, hospital stay, and comp

Procedure: Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study; This study aims to evaluate the outcomes of direct infrapectineal plate fixation in patients with quadrilateral plate acetabular fractures. A total of 25 adult patients with acute fractures were enrolled between 2021 and 2024 at a university-affiliated hospital. All patients underwent surgical fixation through the ilioinguinal approach. Radiological results were assessed using the Matta scoring system, and functional outcomes were evaluated using the Merle d'Aubigné and Postel scoring system. The study further assessed complication rates, operative time, intraoperative blood loss, and hospital stay.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Radiological and Functional Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study	Primary Outcome Measures Description: Radiographic assessment using the Matta scoring system at long-term follow-up. Time Frame: monthly till 4 years postoperatively Description: Postoperative anteroposterior and Judet pelvic radiographs assessed using the Matta scoring system. Reduction quality classified as anatomical (0-1 mm displacement), imperfect (2-3 mm), or poor (>3 mm).Radiological outcome at long-term follow-up Unit of Measure: Number of patients per reduction category	4 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Radiological and Functional Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study	Functional outcome (Merle d'Aubigné and Postel scoring system) Time Frame: monthly till 4 years postoperatively Description: Functional evaluation of hip pain, mobility, and walking ability using the Merle d'Aubigné and Postel scoring system. Outcomes categorized as excellent, good, fair, or poor. Unit of Measure: Number of patients per functional category	4 years

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Radiological and Functional Evaluation of Direct Infrapectineal Plating in Quadrilateral Plate Acetabular Fractures: A Prospective Cohort Study Primary Outcome Measures	Complication rate Time Frame: Within 4 years postoperatively Description: Incidence of postoperative complications including infection, thromboembolic events, implant-related issues, or loss of fixation. Unit of Measure: Number of patients with complications	4 years

Collaborators and Investigators

• Sponsor: Mahmoud Fahmy

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2021
• Primary Completion (Actual): January 1, 2024
• Study Completion (Actual): January 1, 2024

Study Registration Dates

• First Submitted: August 29, 2025
• First Submitted That Met QC Criteria: September 5, 2025
• First Posted (Estimated): September 12, 2025

Study Record Updates

• Last Update Posted (Estimated): September 12, 2025
• Last Update Submitted That Met QC Criteria: September 5, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Surgical fixation; Acetabular fracture; Quadrilateral plate; Ilioinguinal approach
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: MD-350-2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (e.g., baseline demographics, intraoperative details, postoperative outcomes, functional and radiological scores) that underlie the results reported in the publication will be shared. No direct identifiers will be included.
• IPD Sharing Time Frame: De-identified individual participant data (IPD) and supporting materials will be available beginning 12 months after publication of the primary results and will remain available for 36 months thereafter.
• IPD Sharing Access Criteria: Data will be available to qualified researchers with methodologically sound proposals. Requests should be submitted to the corresponding author. Access will be granted following review and approval of the request and execution of a data use agreement. Data will be provided in a secure format (e.g., password-protected files).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No