Application of dynamic anterior titanium plate-screw system assisted by preoperative digital design in treatment of acetabular bi-column fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical efficacy of dynamic anterior plate-screw system(DAPSQ)assisted by preoperative digital design in the treatment of acetabular bi-column fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 34 patients with acetabular bi-column fractures admitted to the General Hospital of Central Theater Command from January 2012 to January 2018.There were 24 males and 10 females,aged 21-65 years [(43.0±14.2)years].According to the treatment method,the patients were divided into Group A treated with DAPSQ assisted by preoperative digital design and Group B treated with conventional DAPSQ.Group A was consisted of 17 patients,including 11 males and six females aged 22-64 years [(42.7±12.4)years].Group B consisted of 17 patients,including 13 males and four females aged 21-65 years [(43.2±14.6)years].The operation time,intraoperative blood loss,hospitalization time,fracture healing time,Matta radiological standard score of fracture reduction,Merle d' Aubignre-Postel score and complications were recorded and compared between the two groups.Results All patients were followed up for 12-62 months [(32.8±9.1)months].The operation time [(160.8±38.5)minutes] and intraoperative bleeding [(455.6±190.4)ml] in Group A were significantly less than those in Group B [(216.9±59.5)minutes] and [(780.2±211.6)ml](P＜0.05).There were no significant differences in hospitalization time,fracture healing time,Matta radiological standard score,modified Merle d' Aubignre-Postel score at the last follow-up between the two groups(P＞0.05).In Group A,four patients had traumatic arthritis,with one patient receiving total hip replacement.In Group B,three patients were found with traumatic arthritis,and one with avascular necrosis of femoral head who underwent total hip replacement.None of the two groups had complications such as screws' entry into articular cavity,failure of internal fixation,and incision infection.Conclusions For acetabular bi-column fractures,DAPSQ can effectively maintain the stability of the fracture,without the risk of screws entering the joint cavity,and obtain satisfactory clinical effect.Compared with conventional DAPSQ,preoperative digital design can significantly shorten the operation time and reduce intraoperative bleeding.