Application of a novel acetabular reduction clamp for treatment of acetabular posterior column fracture / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the effect of our self-developed acetabular reduction clamp in the treatment of fractures of acetabular posterior column.Methods The data were retrospectively analyzed of the 32 patients who had been treated for acetabular posterior column fractures using our self-developed acetabular reduction clamp at Department of Minimally Invasive Surgery,Zhengzhou Orthopaedics Hospital from August 2016 to June 2018.They were 17 males and 15 females,aged from 18 to 62 years (average,41.3 years).According to the Letournel-Judet classification,there were 9 simple posterior column fractures,14 posterior column plus posterior wall fractures,4 T-shaped fractures and 5 double column fractures.The Kocher-Langenbeck (K-L) incision was used for simple posterior column and posterior column plus posterior wall fractures,and the K-L combined with anterior ilioinguinal approach for T-shaped and double column fractures.The displaced posterior column fracture was repositioned with our novel reduction clamp before pelvic reconstruction plate was used for fixation.The quality of fracture reduction,fracture union time,complications and hip function score at the last follow-up were recorded.Results This series of 32 patients were followed up for 7 to 20 months (average,12.9 months).According to the Matta scores for fracture reduction at the last follow-up,15 cases were excellent,16 good and one poor,yielding an excellent and good rate of 96.9％.The fracture union time ranged from 3 to 6 months (average,4.7 months).According to the modified Merle d'Aubign scores at the last follow-up,hip function was excellent in 18 cases,good in 11 and fair in 3,yielding an excellent and good rate of 90.6％.Postoperative symptomatic distraction injury to the sciatic nerve appeared in 2 patients,postoperative wound lipid liquefaction developed in one and heterotopic ossification of Brooker grade Ⅱ was observed in 2 patients during follow-up.Conclusion In the treatment of acetabular posterior column fracture with open reduction and internal fixation with pelvic reconstruction plate through the K-L approach,our novel acetabular reduction clamp can be used safely and effectively to assist fracture reduction,leading to satisfactory results.