Cerclage wiring in displaced associated anterior column and posterior hemi-transverse acetabular fractures

Lin, Hsi‐Hsien; Hung, Shih-Hsin; Su, Yu‐Ping; Chiu, Fang-Yao; Liu, Chien-Lin

doi:10.1016/j.injury.2012.01.016

Cited by 21 publications

(11 citation statements)

References 8 publications

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“…Several modifications of the common iliopectineal plate fixation have been reported (spring plates, infrapectineal plates, cerclages, and lag screws in different positions) [3,4,6,9,13,19,20,23,28,32,35,39] to increase the fracture fixation strength in acetabular surgery. One promising approach, especially for fractures with separation of both columns, is the use of an additional lag screw in the infraacetabular corridor to close the periacetabular fixation frame [7], but biomorphometric data of the corridor size and axis for a secure screw placement are missing.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, several modifications for iliopectineal plate fixation through common anterior approaches (Letournel's ilioinguinal [21], modified Stoppa-Rives [6], or anterior intrapelvic approach [34]) have been described. Spring plates buttressing the quadrilateral plate [6], infrapectineal plates on the inner side of the pelvic rim [13,20,32], placement of additional screws parallel to the quadrilateral plate [21] or in the posterior column [3,19,28,39], and use of cerclage techniques are reported [4,9,23,35].…”

Section: Introductionmentioning

confidence: 99%

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Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Gras

Gottschling

Schröder

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background An infraacetabular screw path facilitates the closure of a periacetabular fixation frame to increase the plate fixation strength in acetabular fractures up to 50%. Knowledge of the variance in corridor sizes and axes has substantial surgical relevance for safe screw placement. Questions/purposes (1) What proportion of healthy pelvis specimens have an infraacetabular corridor that is 5 mm or larger in diameter? (2) Does a universal corridor axis and specific screw entry point exist? (3) Are there sex-specific differences in the infraacetabular corridor size or axis and are these correlated with anthropometric parameters like age, body weight and height, or the acetabular diameter? Methods A template pelvis with a mean shape from 523 segmented pelvis specimens was generated using a CTbased advanced image analyzing system. Each individual pelvis was registered to the template using a free-form registration algorithm. Feasible surface regions for the entry and exit points of the infraacetabular corridor were marked on the template and automatically mapped to the individual samples to perform a measurement of the maximum sizes and axes of the infraacetabular corridor on each specimen. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5-mm cortical screw in clinical settings. Results In 484 of 523 pelves (93%), an infraacetabular corridor with a diameter of at least 5 mm was found. Using the mean axis angulations (54.8°[95% confidence interval {CI}, 0.6] from anterocranial to posterocaudal in relation to the anterior pelvic plane and 1.5°[95% CI, 0.4] from anteromedial to posterolateral in relation to the sagittal midline plane), a sufficient osseous corridor was present in 64% of pelves. Allowing adjustment of the three-dimensional axis by another 5°included an additional 25% of pelves. All corridor parameters were different between females and males (corridor diameter, 6.9 [95% CI, 0

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Gras

Gottschling

Schröder

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…The lag screw fixation was eccentric and could play a certain role in fixation. However, not all acetabular fractures are amenable to the placement of an interfragmentary lag screw (6,7,20), and the fracture may be displaced during tightening of the interfragmentary lag screw (20). …”

Section: Discussionmentioning

confidence: 99%

“…The lag screw through the anterior column to the posterior column would produce a certain clinical result (1,6), but its fixation is eccentric (partial posterior) and requires the fracture blocks of the anterior and posterior columns to not be crushed (6,7). The cerclage wires also produce some good results (8).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

Wu¹,

Cai²,

Liu³

et al. 2013

Clinics

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OBJECTIVE:The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area.METHODS:A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations.RESULTS:As the load was added, the displacements were A

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“…Acetabular fractures continue to be a subject of great interest to the trauma and hip arthroplasty surgeon [1][2][3][4][5][6]. Acetabular injuries associated with traumatic hip dislocation represent rare injuries.…”

Section: Introductionmentioning

confidence: 99%

Central acetabular fracture dislocations: Are existing classifications comprehensive?

Bastian

Giannoudis

2014

Injury

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Cerclage wiring in displaced associated anterior column and posterior hemi-transverse acetabular fractures

Cited by 21 publications

References 8 publications

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

Central acetabular fracture dislocations: Are existing classifications comprehensive?

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