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使用 2.7mmVA LCP 进行粉碎性后髋臼壁骨折的片段特定固定技术:一种新的手术技术。

Fragment specific fixation technique using 2.7 mm VA LCP for comminuted posterior wall acetabular fractures: a novel surgical technique.

机构信息

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.

Department of Orthopedic Surgery, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.

出版信息

Arch Orthop Trauma Surg. 2019 Nov;139(11):1587-1597. doi: 10.1007/s00402-019-03236-1. Epub 2019 Jul 8.

Abstract

PURPOSE

The purposes of the study were to introduce surgical technique of fragment-specific fixation technique using multiple 2.7-mm variable-angle locking compression plates (VA LCPs) in comminuted posterior wall acetabular fractures and reported its clinical results.

PATIENTS AND METHODS

Among the 68 patients, 23 with comminuted posterior wall factures with ≥ 3 fragments in the CT scan and no column involvement with a minimum follow-up duration of 12 months were enrolled in this study. We evaluated the clinical results after the treatment of comminuted posterior wall acetabular fractures via the fragment-specific fixation technique using 2.7-mm variable-angle locking compression plates (VA LCPs) retrospectively.

RESULTS

The average duration of follow-up was 26.8 months. Anatomical reduction was achieved in eighteen patients. Imperfect reduction was achieved in five patients. 22 patients achieved fracture union and one patient underwent revision surgery owing to acute postoperative infection. There were no complications, including loss of reduction, fixative failures, sciatic nerve palsy, heterotopic ossification, and early posttraumatic arthritis among 22 patients. The average functional outcome was measured as 'very good'.

CONCLUSION

Fragment-specific fixation technique using 2.7-mm VA LCPs for comminuted posterior wall acetabular fractures could be an acceptable alternative means of surgical fixation.

摘要

目的

本研究旨在介绍一种使用多块 2.7mm 角度锁定加压接骨板(VA LCP)进行粉碎性后壁髋臼骨折的骨折块特异性固定技术,并报告其临床结果。

患者和方法

在 68 例患者中,有 23 例 CT 扫描显示后壁粉碎性骨折,且≥3 块骨折块,无柱受累,且随访时间至少 12 个月,符合本研究纳入标准。我们回顾性评估了使用 2.7mm 角度锁定加压接骨板(VA LCP)进行骨折块特异性固定治疗粉碎性后壁髋臼骨折的临床结果。

结果

平均随访时间为 26.8 个月。18 例患者获得解剖复位,5 例患者获得非解剖复位。22 例患者骨折愈合,1 例患者因术后急性感染行翻修手术。22 例患者中无并发症发生,包括复位丢失、固定失败、坐骨神经麻痹、异位骨化和早期创伤性关节炎。平均功能评分结果为“非常好”。

结论

对于粉碎性后壁髋臼骨折,使用 2.7mm VA LCP 进行骨折块特异性固定技术是一种可接受的手术固定替代方法。

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