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Title: [Application of new H-shaped anatomical titanium plate for posterior wall/posterior column acetabular fractures].
Author: Huang J, Liao M, Chen X.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Jan 15; 35(1):64-69. PubMed ID: 33448201.
Abstract:
OBJECTIVE: To explore the effectiveness of a new H-shaped anatomical titanium plate in treatment of posterior wall/posterior column acetabular fractures. METHODS: Between March 2012 and April 2019, 46 patients with acetabular fractures involving posterior wall/posterior column were treated with the new H-shaped anatomical titanium plates. There were 28 males and 18 females. The age ranged from 20 to 70 years, with an average of 45.5 years. Among the patients, 34 cases were injured by traffic accidents and 12 cases by falling from height. The time from injury to operation ranged from 2 to 14 days, with an average of 7 days. According to Letournel-Judet classification, there were 12 cases of posterior wall fractures, 1 case of posterior column fracture, 3 cases of transverse fractures, 9 cases of transverse fractures involving posterior walls, 8 cases of posterior column and posterior wall fractures, 2 cases of anterior column and posterior semi-transverse fractures, 3 cases of T-shaped fractures, and 8 cases of double column fractures. Matta reduction standard was used to evaluate fracture reduction and Merle d'Aubign-Postel score was used to evaluate hip joint function. RESULTS: All operations were successfully completed. The time of posterior operation was 60-120 minutes, with an average of 80 minutes. The amount of intraoperative blood loss ranged from 200 to 600 mL, with an average of 300 mL. All the incisions healed by first intention and no infection, deep vein thrombosis, or sciatic nerve injury occurred. All 46 patients were followed up 6-72 months, with an average of 37 months. According to Matta reduction standard, 40 cases obtained anatomic reduction, 4 cases satisfactory reduction, 2 cases unsatisfactory reduction, and the satisfaction rate was 95.7% (44/46). All fractures healed, and the healing time was 3-6 months, with an average of 4.3 months. No internal fixation failure occurred during the follow-up. At last follow-up, the Merle d'Aubign-Postel score ranged from 6 to 18 (mean, 15.5), including 38 cases of excellent, 4 cases of good, 2 cases of fair, and 2 cases of poor, with an excellent and good rate of 91.3% (42/46). Heterotopic ossification occurred in 4 cases, traumatic arthritis in 4 cases, and osteonecrosis of femoral head in 2 cases after operation. CONCLUSION: For acetabular fractures involving posterior wall/posterior column, the new H-shaped anatomical titanium plate can provide stable fixation, satisfactory reduction, and good recovery of hip function. 目的: 探讨新型 H 形解剖钛板治疗髋臼后壁/后柱骨折的疗效。. 方法: 2012 年 3 月—2019 年 4 月，应用新型 H 形解剖钛板治疗 46 例累及后壁/后柱的髋臼骨折患者。男 28 例，女 18 例；年龄 20～70 岁，平均 45.5 岁。致伤原因：交通事故伤 34 例，高处坠落伤 12 例。受伤至手术时间 2～14 d，平均 7 d。Letournel-Judet 分型：后壁骨折 12 例、后柱骨折 1 例、横形骨折 3 例、横形伴后壁骨折 9 例、后柱伴后壁骨折 8 例、前柱伴后半横形骨折 2 例、T 形骨折 3 例、双柱骨折 8 例。术后采用 Matta 评价标准评定骨折复位情况，Merle d’Aubign-Postel 评分标准评价髋关节功能。. 结果: 46 例均顺利完成手术；后路手术时间 60～120 min，平均 80 min；术中出血量 200～600 mL，平均 300 mL。术后切口均 Ⅰ 期愈合，无感染、下肢深静脉血栓形成、坐骨神经损伤等并发症发生。患者均获随访，随访时间 6～72 个月，平均 37 个月。骨折复位根据 Matta 评价标准评定，获解剖复位 40 例、满意复位 4 例、不满意复位 2 例，满意率为 95.7%（44/46）；骨折均愈合，愈合时间为 3～6 个月，平均 4.3 个月；随访期间无内固定失效发生。末次随访时 Merle d’Aubign-Postel 评分为 6～18 分，平均 15.5 分；其中优 38 例、良 4 例、可 2 例、差 2 例，优良率为 91.3%（42/46）。术后 4 例发生异位骨化，4 例发生创伤性关节炎，2 例发生股骨头坏死。. 结论: 对于累及后壁/后柱的髋臼骨折，新型 H 形解剖钛板可以提供牢固固定，术后骨折复位满意，髋关节功能恢复良好。.

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