Reconstruction of Acetabular Posterior Wall Fractures.
10.4055/cios.2011.3.2.114
- Author:
Hui Taek KIM
1
;
Jae Min AHN
;
Jun Oh HUR
;
Jong Seo LEE
;
Sang Jin CHEON
Author Information
1. Department of Orthopaedic Surgery and Medical Research Institute, Pusan National University Hospital, Busan, Korea. kimht@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Acetabulum;
Posterior wall fracture;
Reconstruction
- MeSH:
Acetabulum/*injuries/radiography/*surgery;
Adult;
Aged;
Bone Plates;
Bone Screws;
Bone Transplantation;
Female;
Fracture Fixation, Intramedullary/*methods;
Fractures, Bone/radiography/*surgery;
Humans;
Male;
Middle Aged;
Ossification, Heterotopic;
Surgical Wound Infection;
Treatment Outcome;
Young Adult
- From:Clinics in Orthopedic Surgery
2011;3(2):114-120
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The results after acetabular fracture are primarily related to the quality of the articular reduction. We evaluated the results of internal fixation of posterior wall fractures with using three-step reconstruction. METHODS: Thirty-three patients (mean age at the time of injury, 47.9 years; 28 males and 5 females) were followed for a minimum of 2 years after surgery. The three-step reconstruction included 1) preservation of soft tissues and reduction of the marginally impacted osteochondral (articular) fragments using screws, 2) filling the impacted cancellous void with a bone graft, and 3) reinforcement with buttress-plating. Clinical evaluation was done according to the criteria of D'aubigne and Postel, while the radiological criteria were those of Matta. The associated injuries and complications were evaluated. RESULTS: The clinical results were excellent in 15 (45.5%) patients and they were good in 5 (15.2%), (i.e., satisfactory in 60.7%), while the radiologic results were excellent in 10 (30.3%) and good in 14 (42.4%) (satisfactory in 72.7%). Heterotopic ossification was common, but this did not require excision, even without prophylactic treatment with indomethacin. Deep infection was the worst complication and this was accompanied by a poor outcome. CONCLUSIONS: This study confirms that three-step reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum. Therefore, we anticipate less long-term arthrosis in the patients treated this way.
