Ramos E, Torres A, Callejas E, Micha M, Jorba P, Farah A
Departamento de Ortopedia y Traumatología del Centro Médico American British Cowdray. Ciudad de México.
Servicio de Ortopedia Pediátrica del Hospital Pediátrico Legaria. Ciudad de México.
Acta Ortop Mex. 2018 May-Jun;32(3):118-125.
Quadrilateral plate fractures are the most difficult to reduce and fix. Different techniques have been developed for quadrilateral plate osteosynthesis. The objective of this work was to create an implant and a novel approach to simplify and improve acetabular fracture osteosynthesis.
A total of 83 patients were studied. Pelvic CT scan images of both acetabula were measured at the proximal and distal posterior column. Implant length, diameters and morphological characteristics were determined. The anatomical features of a novel surgical approach are described. The paramedian approach was performed on a cadaveric specimen to determine its anatomical safety.
The screws measured 20 × 6 × 8 mm (length × core diameter x head diameter), with internal threads of 4.5 mm. The Kolmogorov-Smirnov (Lilliefors) test was used, where p had to be 0.05. Plates were previously determined to be 10 mm wide and 3 mm thick, of variable length. Instruments were developed to surmount difficulties.
This new procedure and implant could make the repair of acetabular fractures easier and offers several advantages. Clinical trials are needed to assess the benefits of this proposal. The newly described method can allow acetabular fracture osteosynthesis to be performed safely, avoid iatrogenic injury to anatomical structures and achieve better results.
四边形钢板骨折是最难复位和固定的。已经开发出不同的技术用于四边形钢板接骨术。本研究的目的是创建一种植入物和一种新方法，以简化和改进髋臼骨折接骨术。
共研究了83例患者。在髋臼近端和远端后柱测量双侧髋臼的骨盆CT扫描图像。确定植入物的长度、直径和形态特征。描述了一种新手术方法的解剖学特征。在一具尸体标本上进行旁正中入路以确定其解剖学安全性。
螺钉尺寸为20×6×8毫米（长度×芯直径×头部直径），内螺纹为4.5毫米。使用柯尔莫哥洛夫-斯米尔诺夫（利列福斯）检验，其中p必须为0.05。钢板先前确定为宽10毫米、厚3毫米，长度可变。开发了器械以克服困难。
这种新方法和植入物可使髋臼骨折的修复更容易，并具有若干优点。需要进行临床试验以评估该提议的益处。新描述的方法可使髋臼骨折接骨术安全进行，避免对解剖结构造成医源性损伤并取得更好的效果。
