Journal of Musculoskeletal Trauma

Usefulness of Spring Plate for Acetabular Posterior Wall Fracture Including Small Fragment: Jeong Hoon Kang, Sang Hong Lee, Hyeon Jun Lee; J Korean Fract Soc 2016;29(1):19-25. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.19

PURPOSE
We applied internal fixation using a spring plate against an acetabular posterior wall fracture including small fragments and then evaluated the clinical and radiological results and want to understand the usefulness of the spring plate.
MATERIALS AND METHODS
Fifteen patients in whom fixation was difficult using leg screws or a metal plate because of a small bone fragment, in patients with posterior wall acetabular fractures who presented in our hospital since August of 2011 to March of 2014 were enrolled. The mean age was 42.6 years (range 24-54 years) with relatively young patients, and they were followed-up for at least one year. We analyzed the rate of reduction after surgery using the classification of Matta in radiographs, and the classification of Borrelli in 3-dimensional computed tomography (CT) and clinical results were evaluated using the clinical grading system.
RESULTS
There were five cases of anatomical reduction, 9 cases of imperfect reduction, and 1 case of unsatisfactory reduction according to the classification of Matta. Except for one case during the follow-up period, the union of bone was successful without failure of fixation and the clinical results were 6 cases of excellence, 8 cases of good, and 1 case of failure. Articular displacement was also evaluated in postoperative CT scan according to Borrelli's criteria. The mean of gap and step off was 2.04 mm, 1.3 mm.
CONCLUSION
Use of leg screw fixation and so on in posterior wall fractures including a small fragment of the acetabular rim is not easy. However the method using spring plate fixation enables relatively accurate reduction and fixation for a small fragment and the clinical outcome showed satisfactory results.

Citations

Citations to this article as recorded by

Biomechanical Comparison of Fixation Methods for Posterior Wall Fractures of the Acetabulum: Conventional Reconstruction Plate vs. Spring Plate vs. Variable Angle Locking Compression Plate
HoeJeong Chung, Hoon-Sang Sohn, Jong-Keon Oh, Sangho Lee, DooSup Kim
Medicina.2024; 60(6): 882. CrossRef

33 View
0 Download
1 Crossref

Surgical Treatment of Posterior Wall Fractures of the Acetabulum: Young Soo Byun, Se Ang Chang, Young Ho Cho, Dae Hee Hwang, Sung Rak Lee, Sang Hee Kim; J Korean Fract Soc 2007;20(2):123-128. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.123

Abstract PDF: PURPOSE
To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results.
MATERIALS AND METHODS
Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined.
RESULTS
The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications.
CONCLUSION
In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.

24 View
0 Download

Results of Treatment for Acetabular Fracture involving Posterior Wall: Choong Hee Won, Yong Min Kim, Kyoung Jin Park, Kyoung Il Jeong, Sin No Lee; J Korean Soc Fract 1999;12(4):754-760. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.754

Abstract PDF

The purpose of this study is to analyze the results of treatment of posterior wall fracture of acetabulum, which were treated at our hospital from September 1994 to December 1996. Among 24 posterior wall fractures, 15 cases were confirmed as isolated posterior wall fractures and nine fractures were associated with other acetabular fracture(4 transverse fracture, 3 both column fracture, and 2 posterior column fracture). Clinical follow-up was performed for a minimum of 2 years. The posterior wall fracture was classified according to fracture size(type 1<25%, type 2: 25-50%, type 3: 50-75%, type 4: >75%) and comminution (A: without comminution, B: with comminution, C: impacted) on standard roentgenogram and CT scan. Fourteen among 24 posterior wall fractures were followed for a minimum of 2 years, and the mean Harrif hip score was 91.2. Dislocation of hip occurred in 12 hips(50%). There was no definite difference of Harris hip score in regard to fracture size and comminution of posterior wall. Fractures with posterior hip dislocation had poor result compared with fractures without posterior hip dislocation. Anatomical reduction showed better clinical result than imperfect and poor reductions.

Citations

Citations to this article as recorded by

Surgical Treatment of Posterior Wall Fractures of the Acetabulum
Young-Soo Byun, Se-Ang Chang, Young-Ho Cho, Dae-Hee Hwang, Sung-Rak Lee, Sang-Hee Kim
Journal of the Korean Fracture Society.2007; 20(2): 123. CrossRef

40 View
0 Download
1 Crossref

Surgical Treatment of the Posterior wall Fracture of Acetabulum with Posterior Hip Dislocation: Eu Seup Chung, Kyung Soo Choi, Min Kee Kim, Yong Il Son; J Korean Soc Fract 1996;9(3):525-532. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.525

Abstract PDF

The Posterior wall and column fracture of the acetabulum is clinically important because of its range of motion and weight bearing portion, and in majority cases, they accompany with posterior dislocation of the hip. When the fractures were not treateci well, they may give rise to disabling symptoms such as traumatic arthritis and avascular necrosis of the femoral head. So, accurate reduction is more important than other fractures. The purpose of this study is to know the clinical results and complications when reduced surgically the posterior wall fractures of acetabulum with posterior hip dislocation. Sixteen cases of posterior wall fracture of acetabulum with posterior hip dislocation were treated surgically in the presbyterian medical center during the period 1981 to 1995. The short summary of observations were following as; 1. According to Letoumels classification, simple posterior wall fracture was 10 cases, comminuted posterior wall fracture in 4 cases, and posterior wall and column in 2 cases, and relatively good clinical result was seen at the simple posterior wall fracture. 2. The complications were traumatic osteoarthritis in 4 cases(25%), and heterotopic ossification in 2 cases(12.5%). 3. The clinical result above Good was 14 cases(88%), the roentgenographic result above Good was 11 cases(69%), and they were correlations in each others(P<0.05).

Citations

Citations to this article as recorded by

Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction
Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo
The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef

40 View
0 Download
1 Crossref

Hooked Spring Plate : Its uses in paterior wall acetabular fracture fixation: Joo Chul Ihn, Poong Taek Kim, Dong Kyu Shin; J Korean Soc Fract 1994;7(2):606-615. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.606

Abstract PDF

For fixation of small osteochondral fracture fragment which was difficult to fix with ordinary fixation device in comminuted acetabular posterior wall fracture, we employed a modified 3.5mm one thired tubular plate that was shaped into so-called hooked spring plate. During operation, one end of a plate with two to five hole is flattened for a lenght of 1cm. The flattened end is fashioned into two spikes by trimming the end to the adjacent screw holes with a wire cutter. The resultant spikes are bent to 90 with respect to the plate. The residual proteion of the plates is contoured with convex bow with respect to the surface of the bone. The hooks are placed either through the capsule and around the edge of the fragment or they are embedded into the fragment itself. Six consecutive patients undergoing Kocher-Langenbeck approach for open reduction with internal fixation of posterior wall acetabular fracture(7/91-1.93) were reviewed. There were five simple type and one associated type, as transverse and posterior wall. In two cases application of spring plate in isolation was done. In four cases application of spring plate as part of a reconstruction plate assembly was done All six fractures progressed to union without any loss of the reduction of fixation. In conclusion, the application of spring plate is mechanically sound, valuable for fixation of difficult small osteochondral fractures with avoidance of intaarticular penetration of metal. This method eliminates the need to employ screws in the immediate juxta-articular portion of the plate and promotes early rehabilitation.

Citations

Citations to this article as recorded by

The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate
Dong-Ju Shin, Young-Soo Byun, Se-Ang Chang, Hee-Min Yun, Ho-Won Park, Jae-Young Park
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

38 View
0 Download
1 Crossref

Search