Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA.
Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
J Orthop Trauma. 2018 Feb;32 Suppl 1:S55-S59. doi: 10.1097/BOT.0000000000001089.
Surgical management of comminuted posterior wall acetabular fractures with marginal fragments remains difficult. The purpose of this study was to evaluate the use of spring plates as adjunctive fixation in comminuted posterior wall acetabular fractures.
A retrospective review of patients treated for posterior wall acetabular fractures with the use of customized spring plates as adjunctive fixation between 2000 and 2017 was performed. Patients were evaluated radiographically according to the grading criteria of Matta. Complications including subsequent revision surgery and hardware failure were recorded.
Fifty-two patients underwent surgical fixation of posterior wall acetabular fractures with the use of customized 3.5-mm spring plates combined with posterior buttress compression plating over the spring plates as definitive fixation. Mean follow-up was 13.9 months (range: 3-140 months). Forty-two patients had radiographic grades of excellent, with 6 good, 1 fair, and 3 poor. There were no hardware complications. Five patients underwent revision surgery, including 4 patients (7.7%) who underwent a total hip arthroplasty due to advanced arthritis.
The use of customized spring plates is a viable method of adjunctive fixation for comminuted posterior wall fractures with marginal fragmentation.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
对于存在边缘骨块的粉碎性髋臼后柱骨折，手术治疗仍然具有挑战性。本研究旨在评估使用弹簧钢板作为辅助固定在粉碎性髋臼后柱骨折中的应用。
回顾性分析了 2000 年至 2017 年间使用定制弹簧钢板作为辅助固定治疗髋臼后柱骨折的患者。根据 Matta 分级标准对患者进行影像学评估。记录包括后续翻修手术和内固定失败在内的并发症。
52 例患者接受了手术固定髋臼后柱骨折，使用定制的 3.5mm 弹簧钢板，并在弹簧钢板上进行后柱支撑加压固定作为最终固定。平均随访时间为 13.9 个月（范围：3-140 个月）。42 例患者的影像学分级为优，6 例为良，1 例为可，3 例为差。无内固定并发症。5 例患者接受了翻修手术，其中 4 例（7.7%）因晚期关节炎行全髋关节置换术。
使用定制的弹簧钢板作为辅助固定治疗粉碎性伴边缘骨块的髋臼后柱骨折是一种可行的方法。
治疗性 IV 级。有关证据水平的完整描述，请参见作者说明。
