Yang Deshun, Wang Yangyang, Wang Kaiming, Liao Liang, Lei Bingjun, Huang Zhen, Zhang Qing
Department of Orthopedics, the Third People's Hospital of Bengbu, Bengbu Anhui, 233000, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Oct 15;34(10):1253-1257. doi: 10.7507/1002-1892.202003198.
To explore the effectiveness of the calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach.
Between January 2015 and December 2017, 18 patients with acetabular fracture involving quadrilateral surface were treated with the calcaneal plate bridge reconstruction plate via the modified Stoppa approach. There were 12 males and 6 females. The age ranged from 28 to 63 years (mean, 39 years). The cause of injury was traffic accident in 13 cases and falling from height in 5 cases. According to the Letournel-Judet classification, there were 10 cases of anterior and posterior column fractures, 6 cases of T-shaped fractures, and 2 cases of anterior column and posterior semi-transevere fractures. The interval from injury to operation was 6 to 24 days (mean, 8.6 days). The reduction quality was assessed by postoperative X-ray film and CT according to the criteria proposed by Matta. The hip joint function was assessed by the modified Merled'Aubigné-Postel score.
The operation time was 120-240 minutes (mean, 165 minutes) and the intraoperative blood loss was 600-1 400 mL (mean, 850 mL). All patients were followed up 18-30 months (mean, 24.5 months). There were 2 cases of the fat liquefaction of abdominal incisions, 3 cases of intraoperative injury of lateral femoral cutaneous nerve, 1 case of lower limb thrombosis, and 1 case of abdominal pain and hematuria due to intraoperative accidental bladder injury. According to the criteria proposed by Matta, the reduction quality rated as anatomic reduction in 12 cases, satisfactory reduction in 5 cases, and unsatisfied reduction in 1 case, and the satisfaction rate was 94.4%. All fractures healed with the healing time of 3-5 months (mean, 3.4 months). During follow-up, no internal fixator loosening, breakage, or fracture displacement occurred. At last follow-up, according to modified Merled'Aubigné-Postel score, hip joint functions rated as excellent in 11 cases, good in 4 cases, fair in 2 cases, and poor in 1 case. The excellent and good rate was 83.3%.
Application of calcaneal plate bridge reconstruction plate via the modified Stoppa approach for the acetabular fracture involving the quadrilateral surface can obtain satisfactory effectiveness.
探讨跟骨钢板桥接重建钢板经改良Stoppa入路治疗累及四边形面的髋臼骨折的疗效。
2015年1月至2017年12月，对18例累及四边形面的髋臼骨折患者采用跟骨钢板桥接重建钢板经改良Stoppa入路治疗。其中男12例，女6例。年龄28～63岁，平均39岁。致伤原因：交通事故伤13例，高处坠落伤5例。按Letournel-Judet分型：前后柱骨折10例，T形骨折6例，前柱并后半横行骨折2例。受伤至手术时间为6～24天，平均8.6天。术后根据Matta标准通过X线片及CT评估复位质量。采用改良Merled'Aubigné-Postel评分评估髋关节功能。
手术时间120～240分钟，平均165分钟；术中出血量600～1 400毫升，平均850毫升。所有患者均获随访，随访时间18～30个月，平均24.5个月。发生腹部切口脂肪液化2例，术中损伤股外侧皮神经3例，下肢深静脉血栓形成1例，术中意外膀胱损伤致腹痛、血尿1例。根据Matta标准评估复位质量：解剖复位12例，满意复位5例，不满意复位1例，复位满意率为94.4%。所有骨折均愈合，愈合时间3～5个月，平均3.4个月。随访期间无内固定松动、断裂及骨折移位。末次随访时，根据改良Merled'Aubigné-Postel评分：髋关节功能优11例，良4例，可2例，差1例。优良率为83.3%。
跟骨钢板桥接重建钢板经改良Stoppa入路治疗累及四边形面的髋臼骨折可获得满意疗效。
