Background: The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement.
Methods: We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d'Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables.
Results: We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren't cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05).
Conclusions: The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.
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http://dx.doi.org/10.1186/s12891-021-04908-z | DOI Listing |
Orthop Traumatol Surg Res
December 2024
Groupe Hospitalier Paris Saint Joseph, 185, rue Raymond Losserand, 75014 Paris, France. Electronic address:
J Clin Orthop Trauma
January 2025
Department of Orthopaedics, KEM Hospital, Mumbai, Maharashtra, India.
Matta's Roof Arc Angle (RAA) is utilised to evaluate the load-bearing dome in cases of acetabular fractures, assisting clinicians in making informed decisions regarding treatment options through the measurement of angular displacement. This assessment is crucial for the assessment of acetabular coverage and the stability of the femoral head, helping to determine whether surgical intervention or non-operative approaches are more suitable. Nevertheless, the variability of this method underscores the importance of incorporating additional criteria to ensure the best possible clinical outcomes for patients.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
University of Washington Department of Orthopaedic Surgery and Sports Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Purpose: To assess the rate of heterotopic ossification (HO) following acetabular surgery with a standardized protocol via the Kocher-Langenbeck. Secondarily, to evaluate patient characteristics, injury variables, and perioperative data among patients with HO and no HO.
Methods: This was a retrospective case series from an academic Level I trauma center.
J Bone Joint Surg Am
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: The direct anterior approach (DAA) is a popular approach for primary total hip arthroplasty (THA). However, the contemporary outcomes for DAA THA need further elucidation. Therefore, we aimed to describe implant survivorship, complications, and clinical outcomes after DAA THA.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Resident of Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya - Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Introduction: Hip fractures are common in elderly patients, often accompanied by comorbidities. These fractures can be combined with other injuries, such as a femoral head, neck, or shaft dislocation. The cause of this complex injury is not well-established, but factors like high-energy trauma or falls from a certain height may contribute.
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