Operative treatment of compound acetabular fractures through single posterior approach with percutaneous eannulated screws and reconstruction plates / 中华创伤骨科杂志

ABSTRACT

Objective To discuss the efficacy of a modified single posterior fixation of complicated acetabular fractures with a percutaneous cannulated screw and a reconstruction plate in comparison with traditional bilateral approaches (ilioinguinal and Kocher-Langerbeek). Methods From April 2004 to May 2007, 48 cases of complicated acetabular fracture were treated surgically. By Letoumel classification, 22 were transverse and posterior wall fractures, 16 fractures of both columns, 3 fractures of anterior column and posterior wall, 3 T shape fractures and 4 anterior column and posterior hemi-transverse fractures. Of them, 22 cases were treated through the bilateral approaches and 26 cases through the modified single posterior approach by which a percutuneous cannulated screw was applied, going askew through skin and ischial tuberosity, to fix the anterior column and a reconstruction plate to fix the posterior column. Results Forty patients were followed up for 6 to 37 months(average, 18 months) . There was no statistical difference between the 2 groups as fax as the following factors were concerned anatomic reduction rate and functional good-to-excellent rate. But there were significant differences in operation time and volume of hemorrhage during operation. Conclusion In treatment of complicated acetabular fractures, the modified singl eposterior approach simplifies traditional bilateral approaches so that surgery procedures, perioperative bleeding and postoperative complications can be reduced without sacrificing the treatment efficacy.