Computer-aided design of digital plating for acetabular fracture of posterior wall associated with hip dislocation

Abstract

Objective To evaluate the computer-aided design of digital plating for acetabular fracture of posterior wall associated with hip dislocation. Methods A retrospective study was conducted to analyze the 32 patients who had been admitted for acetabular fracture of posterior wall associated with hip dislocation between June 2012 and August 2016. They were 22 men and 10 women with a mean age of 42.1 years (from 21 to 57 years). They were divided according to the treatment methods into 2 groups: an observational group (n=15) subjected to digital plating and a control group (n=17) subjected to conventional plating. All the patients were treated through the Kocher-Langenbeck approach. For the patients in the observational group, patient-specific digital steel plates were manufactured after simulation of fracture reduction, design of individualized steel plate and simulation of steel plating in the computer software before operation. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative fluoroscopy, hospital stay, fracture reduction and hip joint function at the last follow-up and postoperative complications as well. Results For the observational group, the operation time (73.3±15.2 min) was significantly shorter than that for the control group (93.2±14.7 min), the intraoperative bleeding (254.3±63.1mL) and the intraoperative fluoroscopy (2.4±0.7 times) were significantly less than those for the control group (334.6±70.3 mL; 3.2±0.8 times) (P 0.05). All the patients were followed up for an average of 28.1 months (from 8 to 48 months). There was no significant difference either between the 2 groups in the modified Merle d'Aubigne-Postel scores at the last follow-up (16.4±1.8 versus 15.8±1.6) (P>0.05). There was a significant difference between the observational and control groups in the incidence of heterotopic ossification [6.7% (1/1) versus 17.6% (3/17)] (P<0.05). Conclusions In the treatment of acetabular fracture of posterior wall associated with hip dislocation, computer-aided design of digital plating may have advantages of shorter operation time, less intraoperative blood loss, less intraoperative fluoroscopy and lower incidence of heterotopic ossification. Key words: Acetabulum; Fractures, bone; Fracture fixation, internal; Surgery, computer-assisted; Digitization technology