Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, No. 28 Fuxing Road, Beijing, 100853, China.
Int Orthop. 2021 Oct;45(10):2727-2734. doi: 10.1007/s00264-021-04970-1. Epub 2021 Feb 14.
This study aims to compare the effectiveness of anatomic locking plate and reconstruction plate used in treating acetabular fractures.
From January 2009 to January 2016, patients with acetabular fractures were included in this retrospective study. We grouped the patients into two groups based on the internal fixation: reconstruction plate group (RPG) and anatomic locking plate group (ALPG). The operation time, blood loss, intra-operative screw penetration, and plate breakage were compared between the two groups. The intra-operative fluoroscopic images were used to evaluate the fixation location. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on the Merle d'Aubigne-Postel score.
Eighty-three patients were included in this study and were followed up for an average of 35 months (range, 25 to 42 months). Thirty-five patients were treated with the anatomical locking plate, and 48 patients were treated with the reconstruction plate. The mean surgical time was significantly shorter (P < 0.0001) in ALPG patients than in RPG patients, and the intra-operative blood loss was significantly lower (P = 0.008). The rates of intra-operative screw penetration or plate breakage in the ALPG (0/35) are significantly lower than that in the RPG (7/48) (P = 0.018). Post-operative Matta score (P = 0.905), Merle d'Aubigne-Postel score (P = 0.957), and overall complication rates (P = 0.391) were not significantly different among the groups.
Patients treated by anatomical locking plate had shorter operation time, less bleeding, and lower rate screw perforation compared to patients treated by reconstruction plate. Anatomical locking plate is a better choice for acetabulum fractures, especially complicated fractures.
本研究旨在比较解剖锁定板和重建钢板治疗髋臼骨折的效果。
回顾性分析 2009 年 1 月至 2016 年 1 月收治的髋臼骨折患者，根据内固定方式分为重建钢板组（RPG）和解剖锁定板组（ALPG），比较两组患者的手术时间、出血量、术中螺钉穿透、钢板断裂情况。术中透视图像评估固定位置，根据 Matta 标准评估复位质量和影像学分级，采用 Merle d'Aubigne-Postel 评分进行临床评估。
本研究共纳入 83 例患者，平均随访 35 个月（25~42 个月）。35 例行解剖锁定板固定，48 例行重建钢板固定。ALPG 组手术时间明显短于 RPG 组（P<0.0001），术中出血量明显少于 RPG 组（P=0.008）。ALPG 组术中螺钉穿透或钢板断裂发生率（0/35）明显低于 RPG 组（7/48）（P=0.018）。术后 Matta 评分（P=0.905）、Merle d'Aubigne-Postel 评分（P=0.957）、总并发症发生率（P=0.391）差异均无统计学意义。
与重建钢板相比，解剖锁定板治疗髋臼骨折可缩短手术时间、减少出血量、降低螺钉穿透率，尤其是对于复杂骨折，解剖锁定板是更好的选择。
