Correlation of functional and radiological outcome after surgical treatment of acetabular fractures with quadrilateral plate involvement. A meta-analysis.
Konstantina Solou, Georgios Galanopoulos, John Lakoumentas et al.
✦ AI-curated · Sources linked
In 30 seconds
This meta-analysis examined whether postoperative radiological reduction is associated with functional outcomes after open reduction and internal fixation of acetabular fractures involving the quadrilateral plate. It included 12 prospective or retrospective studies with 336 patients. Overall radiological outcomes were excellent in 66%, good in 27%, and poor in 7%. Agreement between radiological and functional scores was moderate overall, but stronger when comparing excellent with poor outcomes: 95% for MATTA and MAP scores, and 90% for MATTA and HHS scores.
Key findings
- Across 336 patients, MATTA radiological scores were excellent in 66%, good in 27%, and poor in 7%.
- Overall agreement between MATTA and MAP scores was 51% (95% CI 29-71%, I2=85%); excellent-versus-poor agreement was 95%.
- Overall agreement between MATTA and HHS scores was 58% (95% CI 46-71%, I2=43%); excellent-versus-poor agreement was 90%.
- Meta-regression identified no significant predictors of the reported outcomes.
Why it matters
The findings support a relationship between radiological reduction and functional outcome, particularly at the extremes of excellent and poor results. However, moderate overall agreement indicates that radiographic appearance alone does not capture functional recovery. The results also raise questions about how well commonly used functional scores reflect outcomes in this fracture group.
What to keep in mind
The meta-analysis combined prospective and retrospective studies, and agreement estimates showed substantial heterogeneity for MAP versus MATTA (I2=85%).