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

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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.	?李強, 劉國輝, 楊述華, 等. 前后聯合入路治療髖臼骨折并中心性脫位. 中國骨與關節損傷雜志, 2013, 28(4): 301-303.
2.	湯洋, 胡小彭, 陸雄偉, 等. 髖臼后壁骨折固定的生物力學研究. 中國修復重建外科雜志, 2015, 29(8): 925-930.
3.	王雷, 吳嘯波, 齊巍, 等. 四種內固定方法治療髖臼方形區骨折的生物力學比較研究. 中國修復重建外科雜志, 2015, 29(10): 1235-1239.
4.	朱仕文, 王滿宜, 吳新寶, 等. 經單一髂腹股溝入路治療復合髖臼骨折. 中華創傷骨科雜志, 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.	張昊, 胡亞威, 陳少初, 等. 60例復雜髖臼后壁骨折的診治. 中華關節外科雜志(電子版), 2015, 9(2): 211-214.
9.	劉弘揚, 李力更, 吳嘯波, 等. 鎖定重建板不同內固定方式治療髖臼橫形骨折的生物力學研究. 中國修復重建外科雜志, 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.	楊亞軍, 岳建明, 溫鵬. 改良Stoppa入路內側壁彈力接骨板治療累及髖臼方形區骨折. 中國修復重建外科雜志, 2015, 29(3): 270-274.
14.	錢金用, 徐禎書, 胡傳亮, 等. 復雜髖臼骨折的內固定治療策略. 中國骨與關節損傷雜志, 2011, 26(6): 518-519.
15.	王文志, 呂廷灼, 馮世慶. 髖臼骨折的手術治療進展. 中國矯形外科雜志, 2010, 18(16): 1363-1364.
16.	陳學強, 吳群峰, 董衛芹, 等. 骨盆前方有限切開通用重建帶內固定治療髖臼前壁骨折. 中國骨與關節損傷雜志, 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.	秦曉東, 李翔, 呂天潤, 等. 改良髂腹股溝下入路治療髖臼骨折的解剖研究和臨床應用. 中國修復重建外科雜志, 2014, 28(1): 47-52.

1. ?李強, 劉國輝, 楊述華, 等. 前后聯合入路治療髖臼骨折并中心性脫位. 中國骨與關節損傷雜志, 2013, 28(4): 301-303.
2. 湯洋, 胡小彭, 陸雄偉, 等. 髖臼后壁骨折固定的生物力學研究. 中國修復重建外科雜志, 2015, 29(8): 925-930.
3. 王雷, 吳嘯波, 齊巍, 等. 四種內固定方法治療髖臼方形區骨折的生物力學比較研究. 中國修復重建外科雜志, 2015, 29(10): 1235-1239.
4. 朱仕文, 王滿宜, 吳新寶, 等. 經單一髂腹股溝入路治療復合髖臼骨折. 中華創傷骨科雜志, 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. 張昊, 胡亞威, 陳少初, 等. 60例復雜髖臼后壁骨折的診治. 中華關節外科雜志(電子版), 2015, 9(2): 211-214.
9. 劉弘揚, 李力更, 吳嘯波, 等. 鎖定重建板不同內固定方式治療髖臼橫形骨折的生物力學研究. 中國修復重建外科雜志, 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. 楊亞軍, 岳建明, 溫鵬. 改良Stoppa入路內側壁彈力接骨板治療累及髖臼方形區骨折. 中國修復重建外科雜志, 2015, 29(3): 270-274.
14. 錢金用, 徐禎書, 胡傳亮, 等. 復雜髖臼骨折的內固定治療策略. 中國骨與關節損傷雜志, 2011, 26(6): 518-519.
15. 王文志, 呂廷灼, 馮世慶. 髖臼骨折的手術治療進展. 中國矯形外科雜志, 2010, 18(16): 1363-1364.
16. 陳學強, 吳群峰, 董衛芹, 等. 骨盆前方有限切開通用重建帶內固定治療髖臼前壁骨折. 中國骨與關節損傷雜志, 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. 秦曉東, 李翔, 呂天潤, 等. 改良髂腹股溝下入路治療髖臼骨折的解剖研究和臨床應用. 中國修復重建外科雜志, 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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