Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients.


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
30 Dec 2021
Historique:
received: 23 11 2021
accepted: 24 11 2021
entrez: 31 12 2021
pubmed: 1 1 2022
medline: 4 1 2022
Statut: epublish

Résumé

The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement. We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d'Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables. We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren't cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05). The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement.
METHODS METHODS
We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d'Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables.
RESULTS RESULTS
We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren't cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05).
CONCLUSIONS CONCLUSIONS
The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.

Identifiants

pubmed: 34969392
doi: 10.1186/s12891-021-04908-z
pii: 10.1186/s12891-021-04908-z
pmc: PMC8717694
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1060

Informations de copyright

© 2021. The Author(s).

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Auteurs

Gianluca Ciolli (G)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Domenico De Mauro (D)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Giuseppe Rovere (G)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Amarildo Smakaj (A)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Silvia Marino (S)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Lorenzo Are (L)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Omar El Ezzo (O)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Francesco Liuzza (F)

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy. liuzzafrancesco@gmail.com.
Università Cattolica del Sacro Cuore, Rome, Italy. liuzzafrancesco@gmail.com.

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