Mini-plate plus reconstruction plate versus screws plus reconstruction plate for fractures of acetabular posterior wall

Abstract

Objective To compare mini-plate plus reconstruction plate versus screws plus reconstruction plate in the treatment of fractures of acetabular posterior wall. Methods From March 2007 to September 2013, 51 patients with complex fracture of acetabular posterior wall were treated at our department. Twenty-eight patients received operation with mini-plate plus reconstruction plate (mini-plate group), They were 17 males and 11 females, with an average age of 35.3±27.7 years. Twenty-three patients received operation with screws plus reconstruction plate (screws group). They were 14 males and 9 females, with an average age of 38.5±25.8 years. All the operations were conducted through the Kocher-Langenbeck approach. The 2 groups were similar in age, gender, injury side, injury cause, and time from injury to operation. The 2 groups were compared in terms of operation time, intraoperative bleeding, reduction, hip joint function at the last follow-up and postoperative complications. Results The mini-plate and screws groups obtained an average follow-up of 15.4±5.1 months and 18.7±4.2 months respectively. Compared with the screws group, the mini-plate group had significantly shorter operation time (163.5±23.5 min versus 204.2±42.2 min), significantly less intraoperative bleeding (330.0±150.1 mL versus 410.2±164.6 mL), significantly higher modified Merle d'Anbigne-Postel scores at the last follow-up (16.5±1.9 versus 15.2±2.4), and significantly lower postoperative complications [21.4% (6/28) versus 47.8% (11/23)] (all P 0.05). Conclusions Both mini-plate plus reconstruction plate and screws plus reconstruction plate can achieve satisfactory outcomes in treatment of complex fractures of acetabular posterior wall. However, the former may lead to shorter operation time, less invasion, lower rate of postoperative complications and better functional recovery of the hip joint. Key words: Acetabulum; Fractures, bone; Fracture fixation, internal; Bone plates; Bone nails