Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
The second clinical medical college, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Orthop Surg. 2022 Aug;14(8):1583-1592. doi: 10.1111/os.13327. Epub 2022 Jun 15.
In geriatric acetabular fractures, the quadrilateral surface (QLS) was frequently involved in acetabular fracture patterns and accompanied by medial displacement. It was important to buttress the medial displaced QLS and reconstruct the congruity of the affected acetabulum. To evaluate the clinical effectiveness of the novel infra-pectineal quadrilateral surface buttress plates for the treatment of geriatric acetabular fractures.
Twenty-three geriatric patients who were treated for acetabular fractures involving QLS with the novel infra-pectineal buttress plates (NIBP) through a single supra-ilioinguinal approach between January 2015 and June 2019 were retrospectively analyzed; all patients received at least 1 year's follow-up. All patients were aged ≥60 years old and including 18 males and five females. Radiologic and clinical outcomes of patients involved in the study were collated and analyzed according to the Matta scoring system and the Merle D'Aubigné-Postel scoring system. The functional recovery scoring was compared using q-test.
All 23 consecutive patients had relatively satisfactory clinical treatment effectiveness. Average ages, length of incision, operation time, and intraoperative blood loss were 69.8 ± 6.1 years, 12.1 ± 2.6 cm, 166.5 ± 43.5 min, and 500 (500,700) ml, respectively. According to the Matta scoring system, 14 cases of reduction were graded as excellent, five as good, and four as fair. At the last follow-up, the clinical outcome evaluation was excellent in 13 cases, good in seven cases, and poor in three cases with the use of the Merle D'Aubigné-Postel scoring system. The difference of modified Merle D'Aubigne-Postel score at 3 months, 6 months and last follow up was statistically significant (F = 21.56, p < 0.05). Postoperative lateral femoral cutaneous nerve injury occurred in three patients and heterotopic ossification occurred in one patient.
For the treatment of geriatric acetabular fractures, the NIBP could provide stable and effective fixation to the QLS involved acetabular fractures, and related satisfactory clinical results with few complications were noted.
在老年髋臼骨折中，四边形（QLS）表面经常涉及髋臼骨折模式，并伴有内侧移位。支撑内侧移位的 QLS 并重建受影响髋臼的一致性非常重要。评估新型耻骨下四边形支撑板治疗老年髋臼骨折的临床疗效。
回顾性分析 2015 年 1 月至 2019 年 6 月期间通过单一髂腹股沟入路使用新型耻骨下四边形支撑板（NIBP）治疗 QLS 髋臼骨折的 23 例老年患者；所有患者均接受至少 1 年的随访。所有患者年龄均≥60 岁，包括 18 名男性和 5 名女性。根据 Matta 评分系统和 Merle D'Aubigné-Postel 评分系统对纳入研究的患者的影像学和临床结果进行整理和分析。使用 q 检验比较功能恢复评分。
所有 23 例连续患者均具有相对满意的临床治疗效果。平均年龄、切口长度、手术时间和术中失血量分别为 69.8±6.1 岁、12.1±2.6cm、166.5±43.5min 和 500（500，700）ml。根据 Matta 评分系统，14 例复位评为优秀，5 例评为良好，4 例评为一般。末次随访时，采用 Merle D'Aubigné-Postel 评分系统，13 例临床疗效评定为优，7 例为良，3 例为差。改良 Merle D'Aubigné-Postel 评分在 3 个月、6 个月和末次随访时的差异有统计学意义（F=21.56，p<0.05）。术后 3 例发生股外侧皮神经损伤，1 例发生异位骨化。
对于老年髋臼骨折的治疗，NIBP 可为涉及 QLS 的髋臼骨折提供稳定有效的固定，并获得相关的满意临床结果，并发症少。
