全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
PLOS ONE  2014 

Comparative Study of W-Shaped Angular Plate and Reconstruction Plate in Treating Posterior Wall Fractures of the Acetabulum

DOI: 10.1371/journal.pone.0092210

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objective This study aims to assess the medium-term results of the reconstruction of posterior wall fractures using a W-shaped acetabular angular plate (WAAP) compared to those fixed using a reconstruction plate. Methods Between July 2006 and March 2009, we performed a retrospective study, which collected data for any patient treated for a posterior acetabular wall fracture. At the time of treatment, patients were either treated using a WAAP or a pelvic reconstruction plate. The intraoperative fluoroscopic images for both groups were compared. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on a modified Merle d’Aubigne and Postel scoring. Results 53 patients met the inclusion criteria and were followed up for an average of 38 months. 25 patients were treated with a WAAP (study group), and 28 patients were treated with a pelvic reconstruction plate (control group). The intraoperative fluoroscopic images of the study group confirmed extra-articular screw placement in all cases. In the control group, intra-articular screw placement was observed intraoperatively in 5 patients (17.86%), and the definitive location of the periarticular hardware could not be determined in 4 patients (14.29%) during the operation. The differences between the two groups were statistically significant (p = 0.002). In contrast, the quality of fracture reduction, clinical outcomes, and radiological grading in the study group were not significantly different from those of the control group (p>0.05). The radiographic grade was strongly associated with the clinical outcomes in both the study and control groups (p<0.05). Conclusion Reconstruction of posterior wall fractures of the acetabulum using a WAAP can help avoid screw penetration of the hip joint, provide a stable fixation of the posterior wall, and ensure good clinical outcomes.

References

[1]  Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78: 1632–1645. doi: 10.1055/s-0030-1267077
[2]  Porter SE, Schroeder AC, Dzugan SS, Graves ML, Zhang L, et al. (2008) Acetabular fracture patterns and their associated injuries. J Orthop Trauma 22: 165–170. doi: 10.1097/bot.0b013e318165918b
[3]  McMaster J, Powell J (2005) Acetabular fractures. Current Orthopaedics 19: 140–154. doi: 10.1016/j.cuor.2005.03.001
[4]  Norris BL, Hahn DH, Bosse MJ, Kellam JF, Sims SH (1999) Intraoperative fluoroscopy to evaluate fracture reduction and hardware placement during acetabular surgery. J Orthop Trauma 13: 414–417. doi: 10.1097/00005131-199908000-00004
[5]  Carmack DB, Moed BR, McCarroll K, Freccero D (2001) Accuracy of detecting screw penetration of the acetabulum with intraoperative fluoroscopy and computed tomography. J Bone Joint Surg Am 83-A: 1370–1375.
[6]  Stockle U, Schaser K, Konig B (2007) Image guidance in pelvic and acetabular surgery—expectations, success and limitations. Injury 38: 450–462. doi: 10.1016/j.injury.2007.01.024
[7]  Kendoff D, Gardner MJ, Citak M, Kfuri M Jr, Thumes B, et al. (2008) Value of 3D fluoroscopic imaging of acetabular fractures comparison to 2D fluoroscopy and CT imaging. Arch Orthop Trauma Surg 128: 599–605. doi: 10.1007/s00402-007-0411-y
[8]  Richter H, Hutson JJ, Zych G (2004) The use of spring plates in the internal fixation of acetabular fractures. J Orthop Trauma 18: 179–181. doi: 10.1097/00005131-200403000-00010
[9]  Wu X, Chen W, Zhang Q, Su Y, Guo M, et al. (2010) The study of plate-screw fixation in the posterior wall of acetabulum using computed tomography images. J Trauma 69: 423–431. doi: 10.1097/ta.0b013e3181ca05f6
[10]  D'Aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A: 451–475. doi: 10.1055/s-0030-1267120
[11]  Moed BR, Smith ST (1996) Three-view radiographic assessment of heterotopic ossification after acetabular fracture surgery. J Orthop Trauma 10: 93–98. doi: 10.1097/00005131-199602000-00004
[12]  Ficat RP, Arlet J (1980) Necrosis of the femoral head. In: Hungerford DS, editors. Ischemia and necrosis of bone. Baltimore: Williams & Wilkins, pp 171–182.
[13]  Moed BR (2007) Improving results in posterior wall acetabular fracture surgery. J Trauma 62: S63. doi: 10.1097/ta.0b013e318065adb4
[14]  Briffa N, Pearce R, Hill AM, Bircher M (2011) Outcomes of acetabular fracture fixation with ten years' follow-up. J Bone Joint Surg Br 93: 229–236. doi: 10.1302/0301-620x.93b2.24056
[15]  Osgood GM (2009) Posterior wall acetabular fractures: update on surgical indications, fixation techniques and outcome measurements. Curr Orthop Pract 20: 511–521. doi: 10.1097/bco.0b013e3181b3a5f2
[16]  Ebraheim NA, Waldrop J, Yeasting RA, Jackson WT (1992) Danger zone of the acetabulum. J Orthop Trauma 6: 146–151. doi: 10.1097/00005131-199206000-00003
[17]  Ruesch PD, Holdener H, Ciaramitaro M, Mast JW (1994) A prospective study of surgically treated acetabular fractures. Clin Orthop Relat Res (305): 38–46. doi: 10.1097/00003086-199408000-00006
[18]  Oransky M, Sanguinetti C (1993) Surgical treatment of displaced acetabular fractures: results of 50 consecutive cases. J Orthop Trauma 7: 28–32. doi: 10.1097/00005131-199302000-00006
[19]  Gansslen A, Steinke B, Krettek C (2009) [Internal fixation of acetabular posterior wall fractures]. Oper Orthop Traumatol 21: 283–295. doi: 10.1007/s00064-009-1805-5
[20]  Tadros AM, O'Brien P, Guy P (2010) Fixation of marginal posterior acetabular wall fractures using locking reconstruction plates and monocortical screws. J Trauma 68: 478–480. doi: 10.1097/ta.0b013e3181b28aee
[21]  Ebraheim NA, Patil V, Liu J, Sanford CG Jr, Haman SP (2007) Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures. Int Orthop 31: 671–675. doi: 10.1007/s00264-006-0246-0
[22]  Olson SA, Kadrmas MW, Hernandez JD, Glisson RR, West JL (2007) Augmentation of posterior wall acetabular fracture fixation using calcium-phosphate cement: a biomechanical analysis. J Orthop Trauma 21: 608–616. doi: 10.1097/bot.0b013e3181591397
[23]  Goulet JA, Rouleau JP, Mason DJ, Goldstein SA (1994) Comminuted fractures of the posterior wall of the acetabulum. A biomechanical evaluation of fixation methods. J Bone Joint Surg Am 76: 1457–1463. doi: 10.1097/00005131-199212000-00036
[24]  Giannoudis PV, Tzioupis C, Moed BR (2007) Two-level reconstruction of comminuted posterior-wall fractures of the acetabulum. J Bone Joint Surg Br 89: 503–509. doi: 10.1302/0301-620x.89b4.18380

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133