Journal
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Volume 142, Issue 7, Pages 1539-1546Publisher
SPRINGER
DOI: 10.1007/s00402-021-03867-3
Keywords
Acetabular fracture; Bone mass density; Suprapectineal plate; Anatomic plate; Geriatric traumatology
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Funding
- Projekt DEAL
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The study investigated the use of an anatomical-preshaped three-dimensional suprapectineal plate for different types of acetabular fractures. Results showed that this method provided good radiological outcomes in a predominantly geriatric cohort, but impaired bone density significantly increased the risk of poor reduction results.
Purpose To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. Patients and methods A consecutive case series of 50 acetabular fractures (patient age 69 +/- 23 years) treated with suprapectineal anatomic plates were analyzed in a retrospective study. The analysis included: Mechanism of injury, fracture pattern, surgical approach, need for additional total hip arthroplasty, intra- or postoperative complications, as well as bone mass density and radiological outcome on postoperative computed tomography. Results Most frequently, anterior column fracture patterns with and without hemitransverse components as well as associated two column fractures were encountered. The anterior intrapelvic approach (AIP) was used in 98% (49/50) of the cases as primary approach with additional utilization of the first window of the ilioinguinal approach in 13/50 cases (26%). Determination of bone density revealed impaired bone quality in 70% (31/44). Postoperative steps and gaps were significantly greater in this subgroup (p < 0.05). Fracture reduction quality for postoperative steps revealed anatomic results in 92% if the bone quality was normal and in 46% if impaired (p < 0.05). In seven cases (14%), the plate was utilized in combination with acute primary arthroplasty. Conclusion A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.
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