Comparative Results of Acetabular Both Column Fracture According to the Fixation Method

Abstract

Purpose: We wanted to compare the clinical and radiological results of surgical treatment of acetabular both column fracture according to the fixation method. Materials and Methods:Between 1986 and 2008, 55 patients who underwent surgical treatment for acetabular both column fracture were clinically and radiologically evaluated after a minimum follow-up of one year. Of 55 patients, 29 cases were operated with a cerclage wire or cable (group I) and 26 cases were operated with a plate and screw (group II). The surgical approach, the intra-and post-operative complications and the reduction quality were compared between the two groups. The clinical and radiological results were analyzed according to the criteria reported by Matta.Results: There were 14 (48.3%)/20 (76.9%) cases of anatomical reduction, 12 (41.4%)/6 (23.1%) cases of imperfect reduction, 1/0 case of poor reduction and 2/0 cases of surgical secondary incongruence, respectively. Thirty three patients of 34 anatomically reduced patients showed excellent clinical results and the anterior and posterior combined approach was frequent in group I. There were no differences between the two groups for the complications, although intraoperative complication was more frequent in group II and postoperative complication was more frequent in group I. Conclusion:The clinical and radiological results of surgical treatment in patients with both column fracture were satisfactory in both groups. However, the concerns related to the surgical approach and complications will require a randomized prospective study.

Three-Dimensional Printing-Assisted Surgical Technique with Limited Exposure for Both-Column Acetabular Fractures

“…It is essential to achieve anatomical reduction and hip joint congruency, including secondary surgical congruency, of both-column acetabular fractures for rapid postoperative recovery and early rehabilitation as well as maintaining longterm hip joint function. [1][2][3][4][5][6][7] The treatment of both-column acetabular fractures is technically challenging owing to the complex regional anatomy of the pelvis and the complicated fracture configurations. Moreover, these injuries are located deep within the pelvis and are anatomically surrounded by major organs and neurovascular structures; thus, securing an adequate surgical field of view is generally difficult.…”