Application of customized variable-angle locking acetabular wing plates in treatment of acetabular fractures in the elderly via the lateral-rectus approach
10.3760/cma.j.issn.0253-2352.2019.10.002
- VernacularTitle: 经腹直肌外侧入路髋臼翼形全万向锁定钢板固定治疗老年髋臼骨折
- Author:
Han LIU
1
;
Canbin WANG
;
Jiahui CHEN
;
Qiguang MAI
;
Tao LI
;
Hua WANG
;
Yuhui CHEN
;
Cheng YANG
;
Haiyang HUANG
;
Jianwen LIAO
;
Shicai FAN
Author Information
1. Department of Orthopaedics, The Third Affiliated Hospital Of Southern Medical University, Orthopedic Hospital of Guangdong Province, Guangzhou 510630, China
- Publication Type:Clinical Trail
- Keywords:
Acetabulum;
Fracture;
Aged;
Fracture fixation, internal
- From:
Chinese Journal of Orthopaedics
2019;39(10):596-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate clinical efficacy and surgical techniques of customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly through the lateral-rectus approach.
Methods:Data of 11 elder patients of complex acetabular fractures (mean age 75 y, range: 60-93 y; 8 males, 3 females) admitted to our department from March 2016 to March 2017 were retrospectively analyzed. According to Judet-Letournel classification of acetabular fractures, there were 2 cases of anterior column and posterior hemitransverse fractures, 9 cases of both-column fractures. The customized variable-angle locking acetabular wing plates were designed by mimics software and then produced before surgery. During the operation, the customized variable-angle locking acetabular wing plate was applied to reduction and fixation via the anterior lataral-rectus approach. The effect of fracture reduction was assessed by Matta's criteria. The clinical effect was assessed by Harris Hip score and the modified Merle d' Aubigné-Postal score at the 6th month of postoperative follow-up.
Results:The average time of designing and producing customized variable-angle locking acetabular wing plates was 4 d (3-5 d), the average operation time was 95 min (45-150 min), and the average intraoperative bleeding was 600 ml (250-1 400 ml). All patients were followed up, with an average follow-up of 18 m (6-24 m). All fractures were healed, with an average healing time of 8 weeks (6-12 weeks). Reduction quality: excellent in 8 cases, good in 2 cases, poor in 1 case, with an overall excellent and good rate of 90.9%. The result of Harris Hip scoring: excellent in 7 cases, good in 3 cases, and acceptable in 1 case, with a total excellent and good rate of 90.9%; Modified Merle d' Aubigné-Postal soring: excellent in 6 cases, good in 3 cases, and acceptable in 2 cases, with an overall excellent and good rate of 81.8%. There were 2 cases of obturator nerve injury, 1 case of fat liquefaction of incision, 3 cases of traumatic hip arthritis. During the follow-up, no complications such as ectopic ossification, plate fracture and screw loosening were found.
Conclusion:The customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly via the lateral-rectus approach can achieve satisfactory reduction and firm fixtation.
