Navigation-assisted percutaneous anterior column screws and posterior plates for the treatment of associated transverse and posterior wall fractures of the acetabulum
Objective To investigate the clinical outcome of navigation-assisted percutaneous anterior col-umn screws combined with posterior reconstruction plates versus simple posterior reconstruction plates for the treat-ment of associated transverse and posterior wall fractures of the acetabulum. Methods A retrospective cohort study was conducted on the data of 36 patients with associated transverse and posterior wall fractures of the acetabulum,who were admitted to the General Hospital of Central Theater Command from Jan. 2012 to Jan. 2022. There were 22 males and 14 females aged 25-69 (44.9) years,with 25 road traffic injuries,8 falls from height and 3 crush inju-ries. Among them,19 were treated with internal fixation using navigation-assisted percutaneous anterior column screws combined with posterior reconstructive plates and classified into the combined fixation group,while the other 17 cases were treated with posterior reconstruction plates and classified into the simple posterior group. The opera-tion time,intraoperative blood loss and fracture healing time of the two groups were compared. Fracture reduction quality was evaluated using Matta criteria at 2 d postoperatively. The modified Merle d'Aubigné-Postel score was used to evaluate the hip function at 3,6 months and last follow-up. The incidence of postoperative complications was recorded. Results All patients were followed up for 12-44 (mean 22.1) months. Compared with the simple poste-rior group,the combined fixation group showed much longer operation time (min,136.4±8.7 vs. 96.2±13.5),but much quicker fracture healing (weeks,12.7±2.5 vs. 14.9±2.4) and full weight-bearing (weeks,17.4±2.8 vs. 20.0±3.9,all P<0.05). The intraoperative blood loss showed no significant significance between the two groups (P>0.05). At postoperative 2 d,the Matta criteria showed that the anatomical reduction was 84.2％ (16/19) in the combined fixation group with 3 cases of incomplete reduction and 76.5％ (13/17) in the simple posterior group,with 3 cases of incomplete and 1 unsatisfied reduction,revealing no significant difference between the two groups(P>0.05). The modified Merle d'Aubigné-Postel scores at 3 and 6 months follow-up were much better in the com-bined fixation group than in the simple posterior group (P<0.05),which however revealed no significant difference at last follow-up(P>0.05). The incidence of postoperative complications was 21.1％(4/19) in the combined fixa-tion group and 23.5％ (4/17) in the simple posterior group,with no significant difference(P=0.858). Conclusion Posterior reconstruction plate combined with percutaneous anterior column screws in the treatment of associated transverse and posterior wall fractures of the acetabulum can accelerate fracture healing and improve hip functional rehabilitation. The navigation technique can effectively shorten the insertion of anterior column screws,which is worth promotion.
Acetabulum fracturesFracture fixationPlatesNavigation systems
万方数据
维普
