Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System
Objectives To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate–screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. Methods A total of 32 pa...
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doaj-990ec4a1a7994ce496e16b8cebc4a85c2020-11-25T03:05:17ZengWileyOrthopaedic Surgery1757-78531757-78612020-04-0112248849710.1111/os.12648Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw SystemHaiyang Wu0Ranran Shang1Xianhua Cai2Ximing Liu3Chengjing Song4Yanzhao Chen5Department of Orthopaedic Surgery General Hospital of Central Theater Command, Wuhan Clinical Medicine College of Southern Medical University Wuhan ChinaDepartment of Orthopaedic Surgery General Hospital of Central Theater Command Wuhan ChinaGeneral Hospital of Central Theater Command Wuhan Clinical Medicine College of Southern Medical University Wuhan ChinaDepartment of Orthopaedic Surgery General Hospital of Central Theater Command Wuhan ChinaDepartment of Orthopaedic Surgery General Hospital of Central Theater Command Wuhan ChinaDepartment of Orthopaedic Surgery General Hospital of Central Theater Command Wuhan ChinaObjectives To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate–screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. Methods A total of 32 patients with acetabular fractures, selected between January 2009 and March 2016, were managed by DAPSQ with “quadrilateral screws” through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow‐up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss. Results Of these 32 consecutive patients, 19, 9, and 4 were classified as both columns, anterior column posterior hemi‐transverse, and T‐shaped fractures, respectively, and with an average of 47 months’ follow‐up. Anatomic reduction was obtained in 19 cases (59%), imperfect reduction in 9 cases (28%), and poor reduction in 4 cases (13%). The modified Merle d'Aubigné scores were excellent in 15 cases (47%), good in 13 cases (41%), fair in 2 cases (6%), and poor in 2 cases (6%). Three cases sustained temporary lateral femoral cutaneous nerve injuries. One patient had a superficial wound infection that resolved after debridement. Five patients had posttraumatic arthritis; one of them underwent total hip arthroplasty at 46 months. No cases had quadrilateral screws entering the hip joint. Conclusion The use of DAPSQ with quadrilateral screws is an effective and safe choice for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.https://doi.org/10.1111/os.12648Acetabular fractureAcetabulum reconstructionIlioinguinal approachQuadrilateral |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haiyang Wu Ranran Shang Xianhua Cai Ximing Liu Chengjing Song Yanzhao Chen |
spellingShingle |
Haiyang Wu Ranran Shang Xianhua Cai Ximing Liu Chengjing Song Yanzhao Chen Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System Orthopaedic Surgery Acetabular fracture Acetabulum reconstruction Ilioinguinal approach Quadrilateral |
author_facet |
Haiyang Wu Ranran Shang Xianhua Cai Ximing Liu Chengjing Song Yanzhao Chen |
author_sort |
Haiyang Wu |
title |
Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System |
title_short |
Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System |
title_full |
Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System |
title_fullStr |
Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System |
title_full_unstemmed |
Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate–Screw System |
title_sort |
single ilioinguinal approach to treat complex acetabular fractures with quadrilateral plate involvement: outcomes using a novel dynamic anterior plate–screw system |
publisher |
Wiley |
series |
Orthopaedic Surgery |
issn |
1757-7853 1757-7861 |
publishDate |
2020-04-01 |
description |
Objectives To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate–screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. Methods A total of 32 patients with acetabular fractures, selected between January 2009 and March 2016, were managed by DAPSQ with “quadrilateral screws” through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow‐up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss. Results Of these 32 consecutive patients, 19, 9, and 4 were classified as both columns, anterior column posterior hemi‐transverse, and T‐shaped fractures, respectively, and with an average of 47 months’ follow‐up. Anatomic reduction was obtained in 19 cases (59%), imperfect reduction in 9 cases (28%), and poor reduction in 4 cases (13%). The modified Merle d'Aubigné scores were excellent in 15 cases (47%), good in 13 cases (41%), fair in 2 cases (6%), and poor in 2 cases (6%). Three cases sustained temporary lateral femoral cutaneous nerve injuries. One patient had a superficial wound infection that resolved after debridement. Five patients had posttraumatic arthritis; one of them underwent total hip arthroplasty at 46 months. No cases had quadrilateral screws entering the hip joint. Conclusion The use of DAPSQ with quadrilateral screws is an effective and safe choice for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. |
topic |
Acetabular fracture Acetabulum reconstruction Ilioinguinal approach Quadrilateral |
url |
https://doi.org/10.1111/os.12648 |
work_keys_str_mv |
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