Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Deshun ,  WANG Yangyang , WANG Kaiming , LIAO Liang , LEI Bingjun , HUANG Zhen , ZHANG Qing

Department of Orthopedics, the Third People’s Hospital of Bengbu, Bengbu Anhui, 233000, P.R.China;

Corresponding author：

WANG Yangyang, Email: wyylld@qq.com

Keywords：

Acetabular fracture; quadrilateral surface; modified Stoppa approach; calcaneal plate; reconstruction plate; internal fixation

DOI：

10.7507/1002-1892.202003198

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Objective To explore the effectiveness of the calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach.Methods Between January 2015 and December 2017, 18 patients with acetabular fracture involving quadrilateral surface were treated with the calcaneal plate bridge reconstruction plate via the modified Stoppa approach. There were 12 males and 6 females. The age ranged from 28 to 63 years (mean, 39 years). The cause of injury was traffic accident in 13 cases and falling from height in 5 cases. According to the Letournel-Judet classification, there were 10 cases of anterior and posterior column fractures, 6 cases of T-shaped fractures, and 2 cases of anterior column and posterior semi-transevere fractures. The interval from injury to operation was 6 to 24 days (mean, 8.6 days). The reduction quality was assessed by postoperative X-ray film and CT according to the criteria proposed by Matta. The hip joint function was assessed by the modified Merled’Aubigné-Postel score.Results The operation time was 120-240 minutes (mean, 165 minutes) and the intraoperative blood loss was 600-1 400 mL (mean, 850 mL). All patients were followed up 18-30 months (mean, 24.5 months). There were 2 cases of the fat liquefaction of abdominal incisions, 3 cases of intraoperative injury of lateral femoral cutaneous nerve, 1 case of lower limb thrombosis, and 1 case of abdominal pain and hematuria due to intraoperative accidental bladder injury. According to the criteria proposed by Matta, the reduction quality rated as anatomic reduction in 12 cases, satisfactory reduction in 5 cases, and unsatisfied reduction in 1 case, and the satisfaction rate was 94.4%. All fractures healed with the healing time of 3-5 months (mean, 3.4 months). During follow-up, no internal fixator loosening, breakage, or fracture displacement occurred. At last follow-up, according to modified Merled’Aubigné-Postel score, hip joint functions rated as excellent in 11 cases, good in 4 cases, fair in 2 cases, and poor in 1 case. The excellent and good rate was 83.3%.Conclusion Application of calcaneal plate bridge reconstruction plate via the modified Stoppa approach for the acetabular fracture involving the quadrilateral surface can obtain satisfactory effectiveness.

Citation： YANG Deshun, WANG Yangyang, WANG Kaiming, LIAO Liang, LEI Bingjun, HUANG Zhen, ZHANG Qing. Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(10): 1253-1257. doi: 10.7507/1002-1892.202003198 Copy

1.	Andersen RC, O’Toole RV, Nascone JW, et al. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma, 2010, 24(5): 271-278.
2.	黄振飞, 陈开放, 于凌佳, 等. 新型解剖锁定钢板在髋臼前、后柱合并四方区骨折中的应用. 中华骨科杂志, 2017, 37(5): 263-268.
3.	胡维界, 张国劼, 刘峰, 等. 方形区支撑钢板治疗骨质疏松性髋臼骨折. 临床骨科杂志, 2019, 22(4): 424-426.
4.	Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
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.	张里程, 许猛, 何纯青, 等. Kocher-Langenbeck 入路治疗髋臼横形骨折伴后壁骨折疗效分析. 中国修复重建外科杂志, 2010, 24(12): 1428-1431.
7.	李明, 庞清江, 郑琦. 髋臼四方区骨折内固定的研究进展. 中华创伤杂志, 2017, 33(5): 470-474.
8.	Gillispie GJ, Babcock SN, McNamara KP, et al. Biomechanical comparison of intrapelvic and extrapelvic fixation for acetabular fractures involving the quadrilateral plate. J Orthop Trauma, 2017, 31(11): 570-576.
9.	Spitler CA, Kiner D, Swafford R, et al. Generating stability in elderly acetabular fractures-A biomechanical assessment. Injury, 2017, 48(10): 2054-2059.
10.	Karim MA, Abdelazeem AH, Youness M, et al. Fixation of quadrilateral plate fractures of the acetabulum using the buttress screw: A novel technique. Injury, 2017, 48(8): 1813-1818.
11.	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.
12.	陈晓, 马坤龙, 徐海涛, 等. 改良 Stoppa 入路与髂腹股沟入路治疗骨盆、髋臼骨折的 Meta 分析. 中国组织工程研究, 2017, 21(19): 3108-3116.
13.	姚运峰, 薛晨曦, 孙一松, 等. 两种前后联合入路治疗复杂髋臼骨折的疗效比较. 中国修复重建外科杂志, 2018, 32(12): 1512-1517.
14.	薛飞, 贾文超, 武剑, 等. 改良 Stoppa 入路内髂坐钢板固定治疗涉及后柱的髋臼骨折. 中华创伤骨科杂志, 2019, 21(6): 478-483.
15.	Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
16.	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.
17.	张瑞鹏, 尹英超, 李石伦, 等. 髂窝联合 Stoppa 入路方形区解剖钢板固定治疗髋臼双柱骨折. 中华骨科杂志, 2019, 39(13): 781-788.

1. Andersen RC, O’Toole RV, Nascone JW, et al. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma, 2010, 24(5): 271-278.
2. 黄振飞, 陈开放, 于凌佳, 等. 新型解剖锁定钢板在髋臼前、后柱合并四方区骨折中的应用. 中华骨科杂志, 2017, 37(5): 263-268.
3. 胡维界, 张国劼, 刘峰, 等. 方形区支撑钢板治疗骨质疏松性髋臼骨折. 临床骨科杂志, 2019, 22(4): 424-426.
4. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
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. 张里程, 许猛, 何纯青, 等. Kocher-Langenbeck 入路治疗髋臼横形骨折伴后壁骨折疗效分析. 中国修复重建外科杂志, 2010, 24(12): 1428-1431.
7. 李明, 庞清江, 郑琦. 髋臼四方区骨折内固定的研究进展. 中华创伤杂志, 2017, 33(5): 470-474.
8. Gillispie GJ, Babcock SN, McNamara KP, et al. Biomechanical comparison of intrapelvic and extrapelvic fixation for acetabular fractures involving the quadrilateral plate. J Orthop Trauma, 2017, 31(11): 570-576.
9. Spitler CA, Kiner D, Swafford R, et al. Generating stability in elderly acetabular fractures-A biomechanical assessment. Injury, 2017, 48(10): 2054-2059.
10. Karim MA, Abdelazeem AH, Youness M, et al. Fixation of quadrilateral plate fractures of the acetabulum using the buttress screw: A novel technique. Injury, 2017, 48(8): 1813-1818.
11. 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.
12. 陈晓, 马坤龙, 徐海涛, 等. 改良 Stoppa 入路与髂腹股沟入路治疗骨盆、髋臼骨折的 Meta 分析. 中国组织工程研究, 2017, 21(19): 3108-3116.
13. 姚运峰, 薛晨曦, 孙一松, 等. 两种前后联合入路治疗复杂髋臼骨折的疗效比较. 中国修复重建外科杂志, 2018, 32(12): 1512-1517.
14. 薛飞, 贾文超, 武剑, 等. 改良 Stoppa 入路内髂坐钢板固定治疗涉及后柱的髋臼骨折. 中华创伤骨科杂志, 2019, 21(6): 478-483.
15. Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
16. 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.
17. 张瑞鹏, 尹英超, 李石伦, 等. 髂窝联合 Stoppa 入路方形区解剖钢板固定治疗髋臼双柱骨折. 中华骨科杂志, 2019, 39(13): 781-788.

Chinese Journal of Reparative and Reconstructive Surgery

Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach

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