Designation and Validation of a Posterior Anatomical Plate for the Anterior Column of the Acetabulum.

Abstract

BackgroundSurgical treatment of acetabular fractures is one of the greatest challenges for orthopedic surgeons. Fixation of most displaced fractures requires extensive exposure, which may lead to complications, including blood loss, neural or vascular injury, postoperative infection, wound healing problems, and heterotopic bone formation.Material/MethodsThis study was conducted to certify an anatomic plate with an anterior column lag screw guiding device to repair the posterior acetabulum. Complete pelvic spiral computed tomography (CT) scan data were collected from 56 patients. The posterior column of the acetabulum was simulated with a lag screw. The guiding device for the plate was designed by measuring the position of the screw point and the direction and maximum diameter of the screw.ResultsThe distance from the screw point to the apex of the greater sciatic notch was farther in women than in men. The distance from the screw point to the ischial spine was also farther in women than in men. The θ angle (front inclination angle) of the screw was lower in women than in men. The ϕ angle (camber screw angle) was greater in women than in men. The success rate when using the guided device was significantly higher than when using traditional pedicle screws.ConclusionsThe guided device was very useful for improving placement success and accuracy rates of the acetabular posterior anatomical anterior column plate using antegrade lag screws, and for reducing surgical risk and injury.