EFFICACY COMPARISON OF RECONSTRUCTION BELT AND RECONSTRUCTION PLATE FOR COMPLICATED ACETABULAR FRACTURE BY COMBINED ANTERIOR AND POSTERIOR APPROACHES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENLin , ZHANGWei , SHIKe , HANAnping , ZHOUXiaoshu ,  HANZhuang

Department of Orthopedics, the First Affiliated Hospital, China Medical University, Shenyang Liaoning, 110001, P.R.China;

Corresponding author：

HANZhuang, Email: cmuhanzhuang@sina.com

Keywords：

Acetabular fracture; Complicated fracture; Combined anterior and posterior approaches; Reconstruction belt; Reconstruction plate; Internal fixation

DOI：

10.7507/1002-1892.20160138

Video：

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Objective To explore the advantage of reconstruction belt for treating complicated acetabular fracture by combined anterior and posterior approaches through the comparison with reconstruction plate. Methods A retrospective analysis was made on the clinical data of 39 patients with acetabular fractures who met the selection criteria. After open reduction by combined anterior and posterior approaches was performed, fracture was fixed by reconstruction belt in 20 cases (trial group), and by reconstruction plate in 19 cases (control group). There was no significant difference in gender, age, cause of injury, time from injury to hospital, type of fracture, and preoperative visual analogue scale (VAS) score between 2 groups (P > 0.05). The number of plate shaping, plate shaping time, operation time, bleeding amount, perspective times, VAS score, modified Merled’Aubigne-Postel hip score, and related complications were recorded and compared. According to Matta standard, the fracture displacement was measured to evaluate the fracture reduction and fracture healing. Results The number of plate shaping, plate shaping time, operation time, bleeding amount, and perspective times in the trial group were significantly less than those in the control group (P < 0.05). The patients were followed up 12-29 months (mean, 21.1 months) in the trial group, and 12-27 months (mean, 20.5 months) in the control group. The VAS score was significantly lower at 7 days and 6 months after operation than at pre-operation, and at 6 months than at 7 days in 2 groups (P < 0.05), but difference was not significant between 2 groups (P > 0.05). At 6 months after operation, the Merled’Aubigne-Postel score of hip function in the trial group was 15.950±1.504, showing no significant difference when compared with the control group (15.895±1.629) (t= -0.110, P=0.913). The fracture displacement was (0.750±1.070) mm in the trial group and was (0.842±1.068) mm in the control group, showing no significant difference (t= -0.269, P=0.789). The X-ray films showed that all fractures healed in 2 groups. The healing time was (16.10±2.07) weeks in the trial group and was (15.84±2.14) weeks in the control group, showing no significant difference (t =0.382, P=0.075). Conclusion Reconstruction belt for complicated acetabular fracture by combined anterior and posterior approaches has similar effectiveness to reconstruction plate, but the number of plate shaping, plate shaping time, and perspective times are fewer.

Citation： CHENLin, ZHANGWei, SHIKe, HANAnping, ZHOUXiaoshu, HANZhuang. EFFICACY COMPARISON OF RECONSTRUCTION BELT AND RECONSTRUCTION PLATE FOR COMPLICATED ACETABULAR FRACTURE BY COMBINED ANTERIOR AND POSTERIOR APPROACHES. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(6): 680-684. doi: 10.7507/1002-1892.20160138 Copy

1.	李强, 刘国辉, 杨述华, 等. 前后联合入路治疗髋臼骨折并中心性脱位. 中国骨与关节损伤杂志, 2013, 28(4): 301-303.
2.	汤洋, 胡小彭, 陆雄伟, 等. 髋臼后壁骨折固定的生物力学研究. 中国修复重建外科杂志, 2015, 29(8): 925-930.
3.	王雷, 吴啸波, 齐巍, 等. 四种内固定方法治疗髋臼方形区骨折的生物力学比较研究. 中国修复重建外科杂志, 2015, 29(10): 1235-1239.
4.	朱仕文, 王满宜, 吴新宝, 等. 经单一髂腹股沟入路治疗复合髋臼骨折. 中华创伤骨科杂志, 2005, 7(11):1025-1027.
5.	Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg (Am), 1996, 78(11): 1632-1645.
6.	Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
7.	Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
8.	张昊, 胡亚威, 陈少初, 等. 60例复杂髋臼后壁骨折的诊治. 中华关节外科杂志(电子版), 2015, 9(2): 211-214.
9.	刘弘扬, 李力更, 吴啸波, 等. 锁定重建板不同内固定方式治疗髋臼横形骨折的生物力学研究. 中国修复重建外科杂志, 2015, 29(9): 1084-1087.
10.	Laflamme GY, Hebert J. Direct reduction technique for superomedial dome impaction in geriatric acetabular fractures. J Orthop Trauma, 2013, 28(2): 39-43.
11.	Kelly ME, Leonard M, Green C, et al. Should money follow the patient: Financial implication for being the National Centre for the treatment and management of pelvic and acetabular fractures in Ireland. Injury, 2013, 44(12): 1816-1819.
12.	Bishop JA, Rao AJ, Pouliot MA, et al. Conventional versus virtual radiographs of the injured pelvis and acetabulum. Skeletal Radiol, 2015, 44(9): 1303-1308.
13.	杨亚军, 岳建明, 温鹏. 改良Stoppa入路内侧壁弹力接骨板治疗累及髋臼方形区骨折. 中国修复重建外科杂志, 2015, 29(3): 270-274.
14.	钱金用, 徐祯书, 胡传亮, 等. 复杂髋臼骨折的内固定治疗策略. 中国骨与关节损伤杂志, 2011, 26(6): 518-519.
15.	王文志, 吕廷灼, 冯世庆. 髋臼骨折的手术治疗进展. 中国矫形外科杂志, 2010, 18(16): 1363-1364.
16.	陈学强, 吴群峰, 董卫芹, 等. 骨盆前方有限切开通用重建带内固定治疗髋臼前壁骨折. 中国骨与关节损伤杂志, 2013, 28(5): 9-10.
17.	Blokhuis TJ, Frolke JP. Is radiation superior to indomethacin to prevent heterotopic ossification in acetabular fractures?: a systematic review. Clin Orthop Relat Res, 2009, 467(2): 526-530.
18.	秦晓东, 李翔, 吕天润, 等. 改良髂腹股沟下入路治疗髋臼骨折的解剖研究和临床应用. 中国修复重建外科杂志, 2014, 28(1): 47-52.

1. 李强, 刘国辉, 杨述华, 等. 前后联合入路治疗髋臼骨折并中心性脱位. 中国骨与关节损伤杂志, 2013, 28(4): 301-303.
2. 汤洋, 胡小彭, 陆雄伟, 等. 髋臼后壁骨折固定的生物力学研究. 中国修复重建外科杂志, 2015, 29(8): 925-930.
3. 王雷, 吴啸波, 齐巍, 等. 四种内固定方法治疗髋臼方形区骨折的生物力学比较研究. 中国修复重建外科杂志, 2015, 29(10): 1235-1239.
4. 朱仕文, 王满宜, 吴新宝, 等. 经单一髂腹股沟入路治疗复合髋臼骨折. 中华创伤骨科杂志, 2005, 7(11):1025-1027.
5. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg (Am), 1996, 78(11): 1632-1645.
6. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
7. Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
8. 张昊, 胡亚威, 陈少初, 等. 60例复杂髋臼后壁骨折的诊治. 中华关节外科杂志(电子版), 2015, 9(2): 211-214.
9. 刘弘扬, 李力更, 吴啸波, 等. 锁定重建板不同内固定方式治疗髋臼横形骨折的生物力学研究. 中国修复重建外科杂志, 2015, 29(9): 1084-1087.
10. Laflamme GY, Hebert J. Direct reduction technique for superomedial dome impaction in geriatric acetabular fractures. J Orthop Trauma, 2013, 28(2): 39-43.
11. Kelly ME, Leonard M, Green C, et al. Should money follow the patient: Financial implication for being the National Centre for the treatment and management of pelvic and acetabular fractures in Ireland. Injury, 2013, 44(12): 1816-1819.
12. Bishop JA, Rao AJ, Pouliot MA, et al. Conventional versus virtual radiographs of the injured pelvis and acetabulum. Skeletal Radiol, 2015, 44(9): 1303-1308.
13. 杨亚军, 岳建明, 温鹏. 改良Stoppa入路内侧壁弹力接骨板治疗累及髋臼方形区骨折. 中国修复重建外科杂志, 2015, 29(3): 270-274.
14. 钱金用, 徐祯书, 胡传亮, 等. 复杂髋臼骨折的内固定治疗策略. 中国骨与关节损伤杂志, 2011, 26(6): 518-519.
15. 王文志, 吕廷灼, 冯世庆. 髋臼骨折的手术治疗进展. 中国矫形外科杂志, 2010, 18(16): 1363-1364.
16. 陈学强, 吴群峰, 董卫芹, 等. 骨盆前方有限切开通用重建带内固定治疗髋臼前壁骨折. 中国骨与关节损伤杂志, 2013, 28(5): 9-10.
17. Blokhuis TJ, Frolke JP. Is radiation superior to indomethacin to prevent heterotopic ossification in acetabular fractures?: a systematic review. Clin Orthop Relat Res, 2009, 467(2): 526-530.
18. 秦晓东, 李翔, 吕天润, 等. 改良髂腹股沟下入路治疗髋臼骨折的解剖研究和临床应用. 中国修复重建外科杂志, 2014, 28(1): 47-52.

Chinese Journal of Reparative and Reconstructive Surgery

EFFICACY COMPARISON OF RECONSTRUCTION BELT AND RECONSTRUCTION PLATE FOR COMPLICATED ACETABULAR FRACTURE BY COMBINED ANTERIOR AND POSTERIOR APPROACHES

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