经前路单次坐位固定复杂髋臼骨折双柱的耻骨上钢板-突破新的“金标准”

Jujhar Singh, Vedant Bajaj, Karun Jain, Sharandeep Singh Saluja
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引用次数: 0

摘要

前言:髋臼骨折在骨科创伤领域越来越普遍,其外科治疗仍然是外科医生面临的重大挑战。这些骨折的复杂性和可变性通常需要仔细考虑和专业知识,使有效的治疗成为一项艰巨的任务。各种复杂的骨折类型,如前柱和后半横骨折都会影响髋臼的前后柱,传统上采用柱钢板和拉力螺钉固定技术联合治疗。本研究的目的是评估经前路(前盆腔内±改良髂股)使用耻骨上钢板单次固定以前移位为主的复杂髋臼骨折双柱的疗效。材料与方法:对我院三级护理中心1年内31例髋臼骨折伴四边形钢板假体患者进行前瞻性研究。分别于4周、3个月、6个月和1年对患者进行临床和影像学随访。使用视觉模拟量表评分、Harris髋关节评分和Merle d' aubign评分进行功能评估。结果:31例患者入组,平均年龄41.96±13.14岁。平均随访39.09±8.11个月。在我们所有的病例中,髋部复位良好。平均术中出血量为705.48±85.78 mL,输血量为651.61±171.01 mL。在1年的随访中,所有骨折均表现出满意的愈合和持续复位。采用Merle D'Aubigne和Postel分级的1年随访临床结果为61.3%的病例为优,25.8%的病例为良,12.9%的病例为一般。影像学上,2例患者前侧钢板松动;然而,骨折愈合,患者可以满意地进行所有日常生活活动。结论:复杂髋臼骨折需要双柱固定,这种革命性的解剖钢板可以进一步推动前路的界限,并可能成为未来治疗复杂髋臼骨折的新“金标准”,并具有进一步的长期效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Suprapectineal Plate for Fixation of Both Columns of Complex Acetabular Fractures in a Single Sitting through Anterior Approach- Pushing the Boundaries with the New "Gold Standard".

Suprapectineal Plate for Fixation of Both Columns of Complex Acetabular Fractures in a Single Sitting through Anterior Approach- Pushing the Boundaries with the New "Gold Standard".

Suprapectineal Plate for Fixation of Both Columns of Complex Acetabular Fractures in a Single Sitting through Anterior Approach- Pushing the Boundaries with the New "Gold Standard".

Suprapectineal Plate for Fixation of Both Columns of Complex Acetabular Fractures in a Single Sitting through Anterior Approach- Pushing the Boundaries with the New "Gold Standard".

Introduction: Acetabular fractures have increasingly become a prevalent occurrence in the field of orthopedic trauma, and their surgical management continues to present significant challenges for surgeons. The complexity and variability of these fractures often require careful consideration and expertise, making effective treatment a demanding task. Various Complex Fracture patterns, such as anterior column and posterior hemitransverse affect both the anterior and posterior columns of the acetabulum and have been traditionally treated with a combined approach of column plates and lag screw fixation techniques. The aim of this study is to assess the outcomes following fixation of both columns of complex acetabular fractures with predominant anterior displacement, using a suprapectineal plate through Anterior approach (anterior intrapelvic ± Modified Iliofemoral) in a single sitting.

Materials and methods: A hospital-based prospective study was done on 31 patients of acetabular fracture with associated quadrilateral plate component were included in our tertiary care center during 1-year period. Patients were followed up clinically and radiologically at 4 weeks, 3 months, 6 months, and 1 year. Functional assessment was done using the Visual Analog Scale score, Harris Hip Score modified, and Merle d'Aubigné score.

Results: 31 patients were included in the study with a mean age of 41.96 ± 13.14. Average follow-up was 39.09 ± 8.11 months. Excellent reduction with a congruent hip was achieved in all of our cases. The average intra-operative blood loss and transfusion were 705.48 ± 85.78 mL and 651.61 ± 171.01 mL, respectively. At 1-year follow-up, all fractures showed a satisfactory union with maintained reduction. Clinical outcomes at 1-year follow-up using Merle D'Aubigne and Postel grading were excellent in 61.3% cases, good in 25.8% cases, and fair in 12.9% cases. Radiologically, 2 patients had loosening of the plate from the anterior side; however, fracture had united and the patients could perform all the activities of daily living satisfactorily.

Conclusion: Complex acetabular fractures requiring both column fixations with this revolutionary anatomical plate can further push the boundaries of anterior approaches and might be a new "gold standard" for managing complex acetabular fractures in the future with further long-term results.

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