Veliceasa Bogdan, Filip Alexandru, Pertea Mihaela, Popescu Dragos, Carp Claudiu, Alexa Ovidiu
Department of Orthopedics and Traumatology, Surgical Sciences (II), 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.
Department of Plastic Surgery, Surgical Sciences (I), 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.
Exp Ther Med. 2021 Oct;22(4):1064. doi: 10.3892/etm.2021.10498. Epub 2021 Jul 27.
This retrospective study aimed to assess the outcome of a modified Stoppa approach using an anatomically precontoured plate for the treatment of acetabular fractures. In total, 30 patients (mean age 50.3 years; 25 men and 5 women) with acetabular fractures were treated between January 1, 2018 and December 31, 2019. In all 30 cases, fracture reduction was performed through a modified Stoppa approach and fixed with the omega plate. In specific fracture patterns, additional approaches were needed (lateral window in 4 cases and posterior Kocher-Langenbeck approach in 7 cases). Patients were assessed for restoration of the hip joint congruency, complications, and overall fracture reduction. Quality of reduction was categorized based on Matta's radiological principles and to assess functional outcome the Merle d'Aubigné-Postel and Harris hip score was used. The average anesthesia time was 253.6 min, the mean intraoperative blood lost was 266.6 ml and the mean intraoperative fluoroscopy dose was 3.21 mGy. According to Matta criteria for reduction quality, anatomical reduction was recorded in 22 cases, imperfect reduction in 6 cases and 2 cases had poor reduction. The average follow-up was 22.5 months. Malunion, loss of reduction or implant loosening were not recorded. Late complications included one case of avascular necrosis of the femoral head and post-traumatic arthritis changes in 5 cases. At the final follow-up, a mean Merle d'Aubigné-Postel score of 13.26±4.46 and a mean Harris score of 86.03±13.37 were recorded. The possibility of an anatomically precontoured plate with subsequent lower operative time combined with stable fixation of the primary acetabular fracture fragments and the quadrilateral plate makes the omega plate a viable option for treating acetabular fractures with a very low complication rate and good to excellent results in 89% of the cases.
这项回顾性研究旨在评估使用解剖预塑形钢板的改良Stoppa入路治疗髋臼骨折的效果。2018年1月1日至2019年12月31日期间，共治疗了30例髋臼骨折患者（平均年龄50.3岁；25例男性，5例女性）。在所有30例病例中，通过改良Stoppa入路进行骨折复位，并用omega钢板固定。对于特定的骨折类型，需要采用额外的入路（4例采用外侧窗口入路，7例采用后方Kocher-Langenbeck入路）。评估患者髋关节的复位情况、并发症及整体骨折复位情况。根据Matta的放射学原则对复位质量进行分类，并使用Merle d'Aubigné-Postel和Harris髋关节评分来评估功能结果。平均麻醉时间为253.6分钟，平均术中失血量为266.6毫升，平均术中透视剂量为3.21毫戈瑞。根据Matta复位质量标准，22例实现解剖复位，6例复位欠佳，2例复位不良。平均随访时间为22.5个月。未记录到畸形愈合、复位丢失或植入物松动情况。晚期并发症包括1例股骨头缺血性坏死和5例创伤后关节炎改变。在末次随访时，记录到Merle d'Aubigné-Postel平均评分为13.26±4.46，Harris平均评分为86.03±13.37。解剖预塑形钢板结合随后较短的手术时间，以及对髋臼骨折主要碎片和四边形钢板的稳定固定，使得omega钢板成为治疗髋臼骨折的一个可行选择，其并发症发生率极低，89%的病例结果良好至优秀。
