Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Deshun ,  WANG Yangyang , WANG Kaiming , LIAO Liang , LEI Bingjun , HUANG Zhen , ZHANG Qing

Department of Orthopedics, the Third People’s Hospital of Bengbu, Bengbu Anhui, 233000, P.R.China;

Corresponding?author：

WANG Yangyang, Email: wyylld@qq.com

Keywords：

Acetabular fracture; quadrilateral surface; modified Stoppa approach; calcaneal plate; reconstruction plate; internal fixation

DOI：

10.7507/1002-1892.202003198

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Objective To explore the effectiveness of the calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach.Methods Between January 2015 and December 2017, 18 patients with acetabular fracture involving quadrilateral surface were treated with the calcaneal plate bridge reconstruction plate via the modified Stoppa approach. There were 12 males and 6 females. The age ranged from 28 to 63 years (mean, 39 years). The cause of injury was traffic accident in 13 cases and falling from height in 5 cases. According to the Letournel-Judet classification, there were 10 cases of anterior and posterior column fractures, 6 cases of T-shaped fractures, and 2 cases of anterior column and posterior semi-transevere fractures. The interval from injury to operation was 6 to 24 days (mean, 8.6 days). The reduction quality was assessed by postoperative X-ray film and CT according to the criteria proposed by Matta. The hip joint function was assessed by the modified Merled’Aubigné-Postel score.Results The operation time was 120-240 minutes (mean, 165 minutes) and the intraoperative blood loss was 600-1 400 mL (mean, 850 mL). All patients were followed up 18-30 months (mean, 24.5 months). There were 2 cases of the fat liquefaction of abdominal incisions, 3 cases of intraoperative injury of lateral femoral cutaneous nerve, 1 case of lower limb thrombosis, and 1 case of abdominal pain and hematuria due to intraoperative accidental bladder injury. According to the criteria proposed by Matta, the reduction quality rated as anatomic reduction in 12 cases, satisfactory reduction in 5 cases, and unsatisfied reduction in 1 case, and the satisfaction rate was 94.4%. All fractures healed with the healing time of 3-5 months (mean, 3.4 months). During follow-up, no internal fixator loosening, breakage, or fracture displacement occurred. At last follow-up, according to modified Merled’Aubigné-Postel score, hip joint functions rated as excellent in 11 cases, good in 4 cases, fair in 2 cases, and poor in 1 case. The excellent and good rate was 83.3%.Conclusion Application of calcaneal plate bridge reconstruction plate via the modified Stoppa approach for the acetabular fracture involving the quadrilateral surface can obtain satisfactory effectiveness.

Citation： YANG Deshun, WANG Yangyang, WANG Kaiming, LIAO Liang, LEI Bingjun, HUANG Zhen, ZHANG Qing. Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(10): 1253-1257. doi: 10.7507/1002-1892.202003198 Copy

1.	Andersen RC, O’Toole RV, Nascone JW, et al. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma, 2010, 24(5): 271-278.
2.	黃振飛, 陳開放, 于凌佳, 等. 新型解剖鎖定鋼板在髖臼前、后柱合并四方區骨折中的應用. 中華骨科雜志, 2017, 37(5): 263-268.
3.	胡維界, 張國劼, 劉峰, 等. 方形區支撐鋼板治療骨質疏松性髖臼骨折. 臨床骨科雜志, 2019, 22(4): 424-426.
4.	Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
5.	Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg (Am), 1996, 78(11): 1632-1645.
6.	張里程, 許猛, 何純青, 等. Kocher-Langenbeck 入路治療髖臼橫形骨折伴后壁骨折療效分析. 中國修復重建外科雜志, 2010, 24(12): 1428-1431.
7.	李明, 龐清江, 鄭琦. 髖臼四方區骨折內固定的研究進展. 中華創傷雜志, 2017, 33(5): 470-474.
8.	Gillispie GJ, Babcock SN, McNamara KP, et al. Biomechanical comparison of intrapelvic and extrapelvic fixation for acetabular fractures involving the quadrilateral plate. J Orthop Trauma, 2017, 31(11): 570-576.
9.	Spitler CA, Kiner D, Swafford R, et al. Generating stability in elderly acetabular fractures-A biomechanical assessment. Injury, 2017, 48(10): 2054-2059.
10.	Karim MA, Abdelazeem AH, Youness M, et al. Fixation of quadrilateral plate fractures of the acetabulum using the buttress screw: A novel technique. Injury, 2017, 48(8): 1813-1818.
11.	楊亞軍, 岳建明, 溫鵬. 改良 Stoppa 入路內側壁彈力接骨板治療累及髖臼方形區骨折. 中國修復重建外科雜志, 2015, 29(3): 270-274.
12.	陳曉, 馬坤龍, 徐海濤, 等. 改良 Stoppa 入路與髂腹股溝入路治療骨盆、髖臼骨折的 Meta 分析. 中國組織工程研究, 2017, 21(19): 3108-3116.
13.	姚運峰, 薛晨曦, 孫一松, 等. 兩種前后聯合入路治療復雜髖臼骨折的療效比較. 中國修復重建外科雜志, 2018, 32(12): 1512-1517.
14.	薛飛, 賈文超, 武劍, 等. 改良 Stoppa 入路內髂坐鋼板固定治療涉及后柱的髖臼骨折. 中華創傷骨科雜志, 2019, 21(6): 478-483.
15.	Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
16.	王雷, 吳嘯波, 齊巍, 等. 四種內固定方法治療髖臼方形區骨折的生物力學比較研究. 中國修復重建外科雜志, 2015, 29(10): 1235-1239.
17.	張瑞鵬, 尹英超, 李石倫, 等. 髂窩聯合 Stoppa 入路方形區解剖鋼板固定治療髖臼雙柱骨折. 中華骨科雜志, 2019, 39(13): 781-788.

1. Andersen RC, O’Toole RV, Nascone JW, et al. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma, 2010, 24(5): 271-278.
2. 黃振飛, 陳開放, 于凌佳, 等. 新型解剖鎖定鋼板在髖臼前、后柱合并四方區骨折中的應用. 中華骨科雜志, 2017, 37(5): 263-268.
3. 胡維界, 張國劼, 劉峰, 等. 方形區支撐鋼板治療骨質疏松性髖臼骨折. 臨床骨科雜志, 2019, 22(4): 424-426.
4. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res, 1994, (305): 10-19.
5. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg (Am), 1996, 78(11): 1632-1645.
6. 張里程, 許猛, 何純青, 等. Kocher-Langenbeck 入路治療髖臼橫形骨折伴后壁骨折療效分析. 中國修復重建外科雜志, 2010, 24(12): 1428-1431.
7. 李明, 龐清江, 鄭琦. 髖臼四方區骨折內固定的研究進展. 中華創傷雜志, 2017, 33(5): 470-474.
8. Gillispie GJ, Babcock SN, McNamara KP, et al. Biomechanical comparison of intrapelvic and extrapelvic fixation for acetabular fractures involving the quadrilateral plate. J Orthop Trauma, 2017, 31(11): 570-576.
9. Spitler CA, Kiner D, Swafford R, et al. Generating stability in elderly acetabular fractures-A biomechanical assessment. Injury, 2017, 48(10): 2054-2059.
10. Karim MA, Abdelazeem AH, Youness M, et al. Fixation of quadrilateral plate fractures of the acetabulum using the buttress screw: A novel technique. Injury, 2017, 48(8): 1813-1818.
11. 楊亞軍, 岳建明, 溫鵬. 改良 Stoppa 入路內側壁彈力接骨板治療累及髖臼方形區骨折. 中國修復重建外科雜志, 2015, 29(3): 270-274.
12. 陳曉, 馬坤龍, 徐海濤, 等. 改良 Stoppa 入路與髂腹股溝入路治療骨盆、髖臼骨折的 Meta 分析. 中國組織工程研究, 2017, 21(19): 3108-3116.
13. 姚運峰, 薛晨曦, 孫一松, 等. 兩種前后聯合入路治療復雜髖臼骨折的療效比較. 中國修復重建外科雜志, 2018, 32(12): 1512-1517.
14. 薛飛, 賈文超, 武劍, 等. 改良 Stoppa 入路內髂坐鋼板固定治療涉及后柱的髖臼骨折. 中華創傷骨科雜志, 2019, 21(6): 478-483.
15. Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
16. 王雷, 吳嘯波, 齊巍, 等. 四種內固定方法治療髖臼方形區骨折的生物力學比較研究. 中國修復重建外科雜志, 2015, 29(10): 1235-1239.
17. 張瑞鵬, 尹英超, 李石倫, 等. 髂窩聯合 Stoppa 入路方形區解剖鋼板固定治療髖臼雙柱骨折. 中華骨科雜志, 2019, 39(13): 781-788.

Chinese Journal of Reparative and Reconstructive Surgery

Calcaneal plate bridge reconstruction plate for acetabular fracture involving quadrilateral surface via modified Stoppa approach

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