Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, No. 1277, Jiefang Avenue, Jianghan District, Wuhan, Hubei Province, China.
Department of Trauma Surgery, The First Affiliated Hospital of Ningbo University, No.59 Liuting Street, Haishu District, Ningbo, Zhejiang Province, China.
J Orthop Surg Res. 2024 Oct 15;19(1):654. doi: 10.1186/s13018-024-05137-5.
Traditional fixation methods for posterior wall acetabular fractures (PWAFs) typically require the utilization of multiple plates and intraoperative plate contouring, which are technically demanding and carry the risk of intra-articular screw penetration. A novel posterior anatomical integrated locking compression plate (PAILCP) has been designed to optimize these shortcomings. This study aims to evaluate the feasibility and effectiveness of the PAILCP fixation method for the surgical management of PWAFs.
A total of 48 patients with PWAFs who were treated surgically in our department between January 2018 and December 2022 were selected for retrospective analysis. The 48 patients were classified into groups A (PAILCP fixation, n = 25) and B (traditional fixation, n = 23) according to different fixation methods. Fracture reduction quality, number of utilized plates, blood loss, surgical time, instrumentation time, hip function, and complications were compared between the two groups.
A total of 25 PAILCPs were used in group A, while 34 mini-T plates and 29 reconstruction plates were employed in group B. Compared to the patients in group B, those in group A had significantly shorter instrumentation time (- 16 min) and surgical time (- 23 min) as well as lower blood loss (- 123 ml). However, no significant differences were observed in fracture reduction quality and hip function between the two groups. Additionally, the complication rate was slightly lower in group A (3/25 patients) than in group B (6/23); however, this difference was not statistically significant. Finally, follow-up examination revealed no main plate breakage, miniplate displacement, screw loosening, or intra-articular screw penetration in all patients.
The surgical treatment of PWAFs using the PAILCP fixation method results in shorter instrumentation and surgical time and lower blood loss than the traditional fixation method. Thus, the PAILCP fixation method is a promising alternative for PWAFs management, offering enhanced surgical ease and safety.
传统的髋臼后柱骨折（PWAFs）固定方法通常需要使用多块钢板和术中钢板塑形，这不仅技术要求高，而且存在关节内螺钉穿透的风险。一种新型的髋臼后解剖锁定加压钢板（PAILCP）已被设计用来优化这些缺点。本研究旨在评估 PAILCP 固定方法在 PWAFs 手术治疗中的可行性和有效性。
回顾性分析 2018 年 1 月至 2022 年 12 月我院收治的 48 例 PWAFs 患者。根据不同的固定方法，将 48 例患者分为 A 组（PAILCP 固定组，n=25）和 B 组（传统固定组，n=23）。比较两组患者骨折复位质量、钢板使用数量、出血量、手术时间、手术器械时间、髋关节功能及并发症。
A 组共使用 25 块 PAILCP，B 组使用 34 块微型 T 板和 29 块重建钢板。与 B 组患者相比，A 组患者的手术器械时间（-16min）和手术时间（-23min）明显缩短，出血量（-123ml）明显减少。但两组患者骨折复位质量和髋关节功能无显著差异。此外，A 组并发症发生率（3/25 例）略低于 B 组（6/23 例），但差异无统计学意义。最后，随访检查发现所有患者均无主钢板断裂、微型钢板移位、螺钉松动或关节内螺钉穿透。
与传统固定方法相比，PAILCP 固定方法治疗 PWAFs 可缩短手术器械和手术时间，减少出血量。因此，PAILCP 固定方法是 PWAFs 治疗的一种有前途的选择，可提高手术的简便性和安全性。
