• Haiyang Wu, Ranran Shang, Xianhua Cai, Ximing Liu, Chengjing Song, and Yanzhao Chen.
• Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan Clinical Medicine College of Southern Medical University, Wuhan, China.
• Orthop Surg. 2020 Apr 1; 12 (2): 488-497.

ObjectivesTo evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate-screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.MethodsA total of 32 patients with acetabular fractures, selected between January 2009 and March 2016, were managed by DAPSQ with "quadrilateral screws" through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow-up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss.ResultsOf these 32 consecutive patients, 19, 9, and 4 were classified as both columns, anterior column posterior hemi-transverse, and T-shaped fractures, respectively, and with an average of 47 months' follow-up. Anatomic reduction was obtained in 19 cases (59%), imperfect reduction in 9 cases (28%), and poor reduction in 4 cases (13%). The modified Merle d'Aubigné scores were excellent in 15 cases (47%), good in 13 cases (41%), fair in 2 cases (6%), and poor in 2 cases (6%). Three cases sustained temporary lateral femoral cutaneous nerve injuries. One patient had a superficial wound infection that resolved after debridement. Five patients had posttraumatic arthritis; one of them underwent total hip arthroplasty at 46 months. No cases had quadrilateral screws entering the hip joint.ConclusionThe use of DAPSQ with quadrilateral screws is an effective and safe choice for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.© 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

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