Abstract
BackgroundThe 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.MethodsWe 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.ResultsWe 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).ConclusionsThe QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.
Highlights
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
The purpose of this study is to evaluate the use of the suprapectineal QLS plates associated with the Anterior intrapelvic approach to the acetabulum (AIP) approach in the surgical treatment of a series of 34 cases with acetabular fractures with predominantly anterior involvement
We included only isolated anterior column fractures and associated patterns involving the anterior column according to Judet and Letournel classification, over 18 years of age, treated with open reduction and internal fixation using the AIP approach and suprapectineal QLS plate (PRO - Pelvis and Acetabulum System, Stryker, Kalamazoo, MI, USA) with a follow-up more than 1 year
Summary
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. For the specific treatment of this fracture pattern of the acetabulum was introduced new hardware, the suprapectineal quadrilateral surface (QLS) plate, which is mainly used to fix fractures of the anterior column of the acetabulum with the involvement of the quadrilateral lamina. The anterior intrapelvic approach to the acetabulum (AIP) has emerged, in the last two decades, as a promising approach for fixation of anterior acetabular fractures. The purpose of this study is to evaluate the use of the suprapectineal QLS plates associated with the AIP approach in the surgical treatment of a series of 34 cases with acetabular fractures with predominantly anterior involvement
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