Treatment of acetabular fractures with infra-acetabular screwing / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the clinical efficacy of infra-acetabular screwing in the treatment of acetabular fractures.Methods:A retrospective analysis was conducted of the 22 patients with acetabular fracture who had been admitted to Department of Trauma and Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University from January 2016 to January 2019. They were 16 males and 6 females, aged from 19 to 65 years (mean, 45.2 years). According to Letournel-Judet classification, there were 2 anterior column fractures, 12 anterior plus posterior hemi-transverse fractures, 3 T-shaped fractures and 5 both-column fractures. All patients were treated with infra-acetabular screwing through the ilioinguinal approach. Recorded were the patients＇ operation time, intraoperative blood loss, reduction quality, fracture union time, hip function and complications.Results:Operation time for this cohort ranged from 115 to 285 min (mean, 160 min), and intraoperative blood loss from 360 to 1,600 mL (mean, 650 mL). By the Matta scoring, fracture reduction was assessed as excellent in 14 cases, as good in 5 cases and as poor in 3 cases, giving an excellent and good rate of 86.4% (19/22). Of this cohort, 21 were followed up from 12 to 45 months (mean, 28.5 months) and one was lost to the follow-up. The fracture healing time for 21 patients ranged from 1.6 to 3.0 months, averaging 2.2 months. No patient had fracture displacement. The Merle d’Aubigné & Postel hip scores at the last follow-up ranged from 8 to18 points (average, 16 points), giving 12 excellent, 6 good, 2 fair, and one poor cases and an excellent and good rate of 85.7% (18/21). Follow-ups observed injury to the lateral femoral cutaneous nerve in one case, deep venous thrombosis of lower limb in 2 cases, superficial wound infection in one case and traumatic arthritis in one case, yielding a total rate of compilations of 23.8% (5/21).Conclusion:Application of infra-acetabular screwing after anatomical reduction of an acetabular fracture can effectively enhance the strength of internal fixation with no risk of fracture re-displacement, conducive to early functional exercise of the patient and leading to good clinical efficacy.