Are suprapectineal quadrilateral surface buttressing plates performances superior to traditional fixation? A finite element analysis

Acetabular fractures have a high impact on patient’s quality of life, and because acetabular fractures are high energy injuries, they often co-occur with other pathologies such as damage to cartilage that could increase related morbidity; thus, it appears of primary importance developing reliable treatments for this disease. This work aims at the evaluation of the biomechanical performances of non-conservative treatments of acetabular fractures through a finite element approach. Two pelvic plates models (the standard suprapectineal plate—SPP, and a suprapectineal quadrilateral surface buttressing plate—SQBP) were analyzed when implanted on transverse or T-shaped fractures. The plates geometries were adapted to the specific hemipelvis, mimicking the bending action that the surgeon performs on the plate intraoperatively. Implemented models were tested in a single leg stance condition. The obtained results show that using the SQBP plate in transverse and T-shaped acetabular fractures generates lower bone stress if compared to the SPP plate. Interfragmentary movement analysis shows that the SQBP plate guarantees greater stability in transverse fractures. In conclusion, the SQBP plate seems worthy of further clinical analysis, having resulted as a promising option in the treatment of transverse and T-shaped acetabular fractures, able to reduce bone stress values and to get performances comparable, and in some cases superior, to traditional fixation.