Department of Traumatic Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Tianhe District, No.183, Zhongshan Dadao West Street, Guangzhou, 510630, China.
Affiliated Maoming Hospital of Southern Medical University, Maoming, 525000, China.
Arch Orthop Trauma Surg. 2023 Jul;143(7):3669-3675. doi: 10.1007/s00402-022-04546-7. Epub 2022 Jul 19.
This study was aimed to measure the application of W-shaped acetabular angular plate (WAAP) through direct posterior approach (DPA) on the reconstruction of acetabular posterior wall fractures when compared with reconstruction plates.
A retrospective study was performed on patients treated with the WAAP or reconstruction plates via the DPA. The intraoperative data of operative time, blood loss and radiation exposure times were recorded. Radiographs of the pelvis and CT scan were obtained within one week post-operation to assess the reduction quality. The clinical outcome was evaluated by the modified Merle d'Aubigne and Postel score.
From May 2016 to October 2019, a total of 41 patients with simple acetabular posterior wall fractures were included in this study, 22 from the WAAP group and 19 from the reconstruction plates group. There were no significant differences between the two group in age, gender, time from injury to operation, cause of injuries, length of incision and follow-up time (P > 0.05). In comparison with the reconstruction plates group, the average operation time of the WAAP group was significantly shorter (46.1 ± 12.7 min vs 59.2 ± 17.4 min, P < 0.05), the average radiation exposure times were significantly less (2.3 ± 0.6 vs 3.6 ± 1.0, P < 0.001), the average blood loss was significantly less (240 ± 98.9 ml vs 301.1 ± 66.6 ml, P < 0.05). According to Matta radiology criteria and the modified Merle d' Aubigne and Postel score, no significant difference was observed between the two group, as for the quality of reduction and function outcomes.
The application of WAAP through DPA showed satisfactory preliminary clinical outcomes, showing promise to be an alternative technique for the treatment of acetabular posterior wall fractures.
本研究旨在通过直接后入路（DPA）比较 W 形髋臼角钢板（WAAP）与重建钢板在髋臼后壁骨折重建中的应用。
对采用 DPA 行 WAAP 或重建钢板治疗的患者进行回顾性研究。记录手术时间、出血量和放射暴露时间等术中数据。术后 1 周内拍摄骨盆 X 线片和 CT 扫描评估复位质量。采用改良的 Merle d'Aubigne 和 Postel 评分评估临床疗效。
2016 年 5 月至 2019 年 10 月，共纳入 41 例单纯髋臼后壁骨折患者，WAAP 组 22 例，重建钢板组 19 例。两组在年龄、性别、受伤至手术时间、致伤原因、切口长度和随访时间方面差异无统计学意义（P>0.05）。与重建钢板组相比，WAAP 组的手术时间明显缩短（46.1±12.7 min 比 59.2±17.4 min，P<0.05），放射暴露时间明显减少（2.3±0.6 比 3.6±1.0，P<0.001），出血量明显减少（240±98.9 ml 比 301.1±66.6 ml，P<0.05）。根据 Matta 放射学标准和改良的 Merle d' Aubigne 和 Postel 评分，两组在复位质量和功能结果方面无显著差异。
通过 DPA 应用 WAAP 显示出满意的初步临床结果，有望成为治疗髋臼后壁骨折的一种替代技术。
