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Anterior Approach for Fixation of Acetabular Fractures Using Anatomically Designed Plates: Accuracy of Reduction and Early Functional Outcomes With a Minimum of 1-Year Follow-Up
Journal of Orthopaedic Trauma ( IF 1.6 ) Pub Date : 2022-09-01 , DOI: 10.1097/bot.0000000000002369
Mohamed A Khalefa 1, 2 , Walid A El Nahal 1, 2 , Mahmoud Abdel Karim 2 , Khaled F M Abdel-Kader 2 , Timothy John Sloan Chesser 3 , Anthony J Ward 3 , Mehool Acharya 3
Affiliation  

Objectives: 

To evaluate the results of a new plate system using anterior approaches in the management of acetabular fractures.

Design: 

Retrospective case-note review.

Setting: 

Pelvic and acetabular tertiary center.

Patients and intervention: 

A consecutive series of acetabular fractures treated using only anterior approach and anatomical plates, at one tertiary specialist unit, were reviewed. The fracture patterns, incisions used, intraoperative and postoperative complications, reduction achieved (measured on postoperative radiographs and computed tomography scans), and early postoperative results (minimum 1-year follow-up) were recorded.

Main Outcome measurement: 

Postoperative reduction (measured by postoperative plain radiographs and computed tomography).

Results: 

Thirty-three patients (mean age, 57 years) underwent reconstruction with the anatomical plates using anterior approaches. Associated both columns and anterior column posterior hemitransverse represented most of the patients (85%). The fracture pattern was complex with quadrilateral plate involvement in 79% of cases. Overall, anatomic reduction was seen in 82% on plain radiographs and CT scan evaluation. Increasing age was a statistically significant variable in obtaining anatomical reduction with an age cutoff value of 70 years (P 0.012). Associated both column fractures were associated with a lower incidence of anatomical reduction (P = 0.038). Complication rates were comparable with the literature. 22 patients (71%) were symptom free, with 20 patients (62.5%) having excellent radiographic outcomes at the latest follow-up.

Conclusions: 

The results suggested that using approach-specific instruments and anatomical plates through anterior approaches in a specialized unit led to anatomical reconstruction in 82% with patients demonstrating satisfactory early radiological and functional outcomes at 1 year.

Level of Evidence: 

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.



中文翻译:

使用解剖学设计的钢板固定髋臼骨折的前路方法:复位的准确性和早期功能结果,至少 1 年的随访

目标: 

评估使用前路方法治疗髋臼骨折的新钢板系统的结果。

设计: 

回顾性案例笔记审查。

环境: 

骨盆和髋臼三级中心。

患者和干预: 

回顾了在一个三级专科单位仅使用前路和解剖板治疗的一系列髋臼骨折。记录骨折类型、使用的切口、术中和术后并发症、达到的复位(通过术后 X 光片和计算机断层扫描测量)和术后早期结果(至少 1 年随访)。

主要成果测量: 

术后复位(通过术后平片和计算机断层扫描测量)。

结果: 

33 名患者(平均年龄 57 岁)使用前路方法使用解剖板进行了重建。相关的柱和前柱后半横切代表了大多数患者(85%)。骨折模式复杂,79% 的病例有四边形钢板受累。总体而言,在 X 线平片和 CT 扫描评估中,有 82% 的患者出现解剖学缩小。年龄增长是获得解剖学减少的一个统计学显着变量,年龄截止值为 70 岁(P < 0.012)。与两种柱骨折相关的解剖复位发生率较低(P= 0.038)。并发症发生率与文献相当。22 名患者 (71%) 无症状,20 名患者 (62.5%) 在最近一次随访时影像学结果良好。

结论: 

结果表明,在专门的单元中通过前路入路使用入路专用器械和解剖板导致 82% 的患者在 1 年时表现出令人满意的早期放射学和功能结果。

证据等级: 

治疗级别 I。有关证据级别的完整描述,请参见作者说明。

更新日期:2022-08-19
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