Pelvis Fracture and Arthroplasty Unit, Kasr Alainy Hospital, Orthopaedic Department, Cairo University, Cairo, Egypt.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1277-1284. doi: 10.1007/s00068-021-01629-9. Epub 2021 Mar 7.
Different reduction techniques and tools are described to facilitate anatomical reduction of acetabular fractures. However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This study aims at radiological and functional assessment of the effectiveness of a novel reduction technique for the posterior column element in displaced acetabular fractures.
A prospective study was conducted for evaluation of a novel reduction technique; the use of the conventional large holding Verbrugge forceps for reduction of posterior column and transverse, with or without posterior wall, fractures. Intra-operative safety and reduction time were evaluated. The immediate postoperative quality of reduction was assessed using Matta radiographic criteria. The functional outcome was evaluated at the latest follow-up visit using the modified Merle d'Aubigne and Postel (MDP) score.
Thirty patients with a mean follow-up of 18.1 months were included. Fifteen had transverse/posterior wall, ten had transverse, and five had posterior column fractures. All fractures were displaced ≥ 2 mm on anteroposterior and/or Judet views of the pelvis without traction. The average operative time was 100.4 min with 12.5 min reduction time. No intra-operative complications were encountered. Twenty-three patients (76.6%) had anatomical while seven (23.3%) had imperfect reduction. The functional outcome score was excellent in three patients, good in 18, fair in four, and poor in five patients at the latest follow-up.
The use of the conventional large Verbrugge bone-holding forceps for the reduction of the posterior column element in displaced acetabular fractures using the Kocher-Langenbeck approach is a safe, effective, time-saving, and technically undemanding procedure.
描述了不同的复位技术和工具，以促进髋臼骨折的解剖复位。然而，由于现有的复位工具占据了较大的表面积，因此复位的维持、钢板放置和骨折固定仍然是一个挑战。本研究旨在评估一种新型复位技术对移位髋臼骨折后柱部分的有效性，进行影像学和功能评估。
前瞻性研究评估一种新型复位技术；使用传统的大型Verbrugge 持骨钳复位后柱和横形、合并或不合并后壁骨折。评估术中安全性和复位时间。使用 Matta 放射学标准评估即刻术后复位质量。使用改良的 Merle d'Aubigne 和 Postel (MDP) 评分在最新随访时评估功能结果。
共纳入 30 例患者，平均随访 18.1 个月。15 例为横形/后壁骨折，10 例为横形骨折，5 例为后柱骨折。所有骨折在骨盆前后位和/或 Judet 位片上均有移位≥2mm，且未行牵引。平均手术时间为 100.4 分钟，复位时间为 12.5 分钟。术中未发生并发症。23 例（76.6%）获得解剖复位，7 例（23.3%）获得不完美复位。在最新随访时，功能结果评分优 3 例，良 18 例，可 4 例，差 5 例。
使用 Kocher-Langenbeck 入路，传统的大型 Verbrugge 持骨钳复位移位髋臼骨折后柱部分是一种安全、有效、节省时间且技术要求不高的方法。
