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Yonghong D, Yanhui Z. TiRobot ForcePro Superior combined with suture-button plates for minimally invasive treatment of an acetabular both-column fracture - a case report. BMC Musculoskelet Disord 2025; 26:356. [PMID: 40217215 PMCID: PMC11992791 DOI: 10.1186/s12891-025-08573-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 03/24/2025] [Indexed: 04/14/2025] Open
Abstract
BACKGROUND The acetabulum exhibits an irregular anatomical structure with a dense concentration of critical blood vessels and nerves in its vicinity. Acetabular fractures accompanied by periarticular soft tissue injuries may lead to life-threatening complications. The Letournel-Judet classification system is currently the widely adopted standard for categorizing acetabular fractures, with the both-column fracture type recognized as the most complex pattern within this framework. Open reduction and internal fixation remains the gold standard for its management. The minimally invasive closed reduction of acetabular both-column fractures with significant displacement remains an unresolved global challenge in orthopedic surgery. Our surgical team has developed an innovative approach that provides a novel solution to this complex clinical problem. Therefore, this article was compiled to provide a comprehensive description of this surgical technique, thereby offering novel insights for the orthopedic surgeons. CASE PRESENTATION A 33-year-old male patient sustained a left-sided acetabular both-column fracture due to a high-altitude fall. Under the guidance of the TiRobot ForcePro Superior, we first established a bony channel, then passed a suture-button plate through the quadrilateral plate of the acetabulum. Subsequently, high-strength sutures were tightened using a suture tensioner to achieve compression reduction of the fracture fragments. Following reduction, screws were inserted with robotic assistance via the TiRobot ForcePro Superior to achieve rigid fixation of the fracture site. The patient underwent an 11-month follow-up. Radiographic evidence of bony consolidation was confirmed at the 4th postoperative month, with no traumatic arthritis observed throughout the follow-up period. Pelvic function demonstrated excellent recovery, achieving a Majeed Pelvic Function Score of 92 points. There was virtually no difference in the patient's function regarding sitting, walking, standing, and sexual activity compared to pre-injury, and no gait alteration was observed. CONCLUSIONS With the assistance of robot-aided surgery combined with suture-button plates, our surgical team successfully achieved minimally invasive closed reduction and internal fixation for an acetabular both-column fracture. This innovative surgical approach provides a novel strategy for the minimally invasive management of acetabular both-column fractures.
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Affiliation(s)
- Dai Yonghong
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Zeng Yanhui
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China.
- Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China.
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Ahmadi MA, Moein SA, Fereidooni R, Ayatizadeh SH. Use of calcaneal locking plate in surgical treatment of quadrilateral plate fractures of the acetabulum. Musculoskelet Surg 2024; 108:431-436. [PMID: 38814429 DOI: 10.1007/s12306-024-00830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Specialized devices for fixation of the acetabulum quadrilateral plate (QP) fractures may not be readily available in resource-constrained settings. In this article, we aim to explore the use of a 3.5-mm locking calcaneal plate in fixation of QP fractures. METHODS Twenty-eight patients with QP fractures underwent surgery using the modified Stoppa approach. Follow-up at 12 months assessed fracture healing and functional outcomes using the Majeed pelvic outcome score. Descriptive statistics summarized patient demographics and fracture characteristics. Analysis of variance (ANOVA) and exact logistic regression explored associations between factors (age, AO/OTA classification, gender, and time to surgery) and Majeed scores. RESULTS The mean age of patients was 42.71 years, with the majority being male (64.29%). All patients achieved bony union. Post-traumatic arthritis developed in three patients, while two patients experienced post-operative fracture redisplacement. Evaluation using the Majeed pelvic outcome score revealed generally favorable outcomes, with 32.14% achieving excellent, 39.29% good, 21.43% fair, and 7.14% poor outcome. Only an older age was associated with a worse outcome score (excellent/good versus fair/poor, odds ratio: 0.87, 95% confidence interval: 0.77, 0.96). CONCLUSION Surgical management of quadrilateral plate fractures using 3.5-mm locking calcaneal plates demonstrates promising outcomes, particularly in resource-constrained settings, where specialized devices may be lacking.
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Affiliation(s)
- Mohammad Amin Ahmadi
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Arman Moein
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Reza Fereidooni
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Hamidreza Ayatizadeh
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Campos TVDO, Reis IGN, Molina SES, da Costa GSM, Domingues AG, Gomes PDTC, de Andrade MAP. Off-Label Use of Buttress Calcaneal Plate in Medial Distal Femoral Fracture to Augment Internal Fixation. JBJS Essent Surg Tech 2024; 14:e23.00088. [PMID: 39193040 PMCID: PMC11346833 DOI: 10.2106/jbjs.st.23.00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024] Open
Abstract
Background High-energy traumatic fractures represent a challenge for orthopaedic surgeons because there are a great variety of morphologic patterns and associated injuries1. Although the incidence is higher in developing countries, these fractures pose a major financial burden all over the world because of their considerable hospital length of stay, time away from work, rate of failure to return to work, complications, and cost of treatment2-4. Since the fracture patterns are so variable, some cases may have a lack of available specific osteosynthesis implants, despite recent advancements in implant engineering5. However, experienced surgeons are capable of using their knowledge and creativity to treat challenging lesions with use of preexisting plates while following the principles of fracture fixation and without compromising outcomes. In 2012, Hohman et al. described for the first time the use of a calcaneal plate to treat distal femoral fractures6. In 2020, Pires et al. further expanded the indications for use of a calcaneal plate5. This technical trick is widely utilized in our trauma center, especially in comminuted fractures around the knee. The present video article provides a stepwise description of the off-label use of a calcaneal plate in a medial distal femoral fracture. Description The key principles of this procedure involve following common fundamentals during open reduction and internal fixation, approaching the fracture, preserving soft-tissue attachments of the comminution, and reducing the main fragments. Afterwards, the off-label use of a calcaneal plate adds the special feature of being able to contain fracture fragments with plate contouring. If necessary and if osseous morphology allows, bone grafting through the plate may also be performed. Alternatives Multiple fixation implants can be utilized in medial distal femoral fractures. Surgeon-contoured plates (i.e., locking compression plates or low-contact dynamic compression plates), multiple mini-fragment plates, cortical screws alone, cannulated cancellous screws alone, or proximal humeral plates are among the alternatives5-9. However, the lack of specific implants for fixation of fractures involving the medial femoral condyle is notable, even in developed countries10. Rationale The small-fragment calcaneal plate is a widely available and cheaper implant compared with locking compression plates, which is especially important in developing countries. Additionally, this plate has a lower profile, covers a greater surface area, and allows multiple screws in different planes and directions. The use of this plate represents a great technical trick for surgeons to contain comminution. Expected Outcomes Patient education regarding fracture severity is mandatory, and it is important to highlight that there is no current gold standard to treat these fractures because of the wide variability of morphological patterns. To our knowledge, all studies reporting the use of a calcaneal plate to treat these fractures have shown promising results, including good functional outcomes and 100% fracture healing with no cases of nonunion, infection, or implant failure5,6,10-14. In the largest case series to date, Shekar et al. performed an interventional prospective study of 30 patients undergoing calcaneal plating for distal femoral unicondylar fractures14. They reported a mean range of motion of 108° ± 28.27° at 6 months, with excellent or satisfactory results in 80% of patients as measured with use of the Neer scoring system14. Important Tips Preserve the blood supply by performing minimal soft-tissue dissection.Do not detach comminuted fragments from the soft tissues, which will help fracture reduction.Reduce the main fragments anatomically and fix as necessary.Contain the comminution using the spanning property and large covering area of the calcaneal plate.Perform bone grafting through the plate as necessary.
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Affiliation(s)
- Túlio Vinícius de Oliveira Campos
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
- Biocor Instituto, Nova Lima, Minas Gerais, Brazil
| | - Igor Guedes Nogueira Reis
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
| | - Santiago Enrique Sarmiento Molina
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo Scarpelli Martins da Costa
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
| | - André Guerra Domingues
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo de Tarso Cardoso Gomes
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital Risoleta Tolentino Neves, FUNDEP, Belo Horizonte, Minas Gerais, Brazil
- Biocor Instituto, Nova Lima, Minas Gerais, Brazil
| | - Marco Antônio Percope de Andrade
- Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Biocor Instituto, Nova Lima, Minas Gerais, Brazil
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Tosyalı HK, Elibol FKE, Hancıoğlu S, Kaçmaz SE, Çalışkan Öİ, Tolunay T, Demir T, Okçu G. Which implant is better for the fixation of posterior wall acetabular fractures: A conventional reconstruction plate or a brand-new calcaneal plate? Injury 2024; 55:111413. [PMID: 38394707 DOI: 10.1016/j.injury.2024.111413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Increased posterior wall acetabular fractures among older adults, require precise treatment to restore stability to the joint, lower the risk of degenerative arthritis, and enhance overall functional recovery. The purpose of this study was to compare the fixation stability and mechanical characteristics of calcaneal buttress plate and conventional reconstruction plate under different loading condition. METHODS Typical acetabular posterior wall fractures were created on twenty synthetic hemipelvis models. They were fixed with calcaneus plate and reconstruction plate. Dynamic and static tests were performed. Displacements of fracture line and stiffness were calculated. FINDINGS After dynamic loading, calcaneus plate fixation has significantly less displacement than the reconstruction plate on the superior posterior wall. Under static loading condition, the calcaneus plate group has significantly less displacement than the reconstruction plate group on the inferior posterior part of the fracture. The average stiffness values of the calcaneus plate group and the reconstruction plate group were 265.16±53.98 N/mm and 167.48±36.87 N/mm, respectively and a statistically significant difference was found between the two groups. INTERPRETATION The calcaneal plate group demonstrated better stability along the fracture line after dynamic and static loading conditions. Especially when the fragment was on the acetabulum's superior posterior, inferior posterior, and inferior rim, Calcaneal buttress plates offer biomechanically effective choices.
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Affiliation(s)
- Hakan Koray Tosyalı
- Department of Orthopedics and Traumatology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatma Kübra Erbay Elibol
- Department of Biomedical Engineering, TOBB University of Economics and Technology, Ankara, Turkey.
| | - Sertan Hancıoğlu
- Department of Orthopedics and Traumatology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Suat Emre Kaçmaz
- Department of Orthopedics and Traumatology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Özde İrem Çalışkan
- Department of Biomedical Engineering, TOBB University of Economics and Technology, Ankara, Turkey
| | - Tolga Tolunay
- Department of Orthopedics and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Teyfik Demir
- Department of Mechanical Engineering, TOBB University of Economics and Technology, Ankara, Turkey
| | - Güvenir Okçu
- Department of Orthopedics and Traumatology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Hussain Z, Parmeshwar SS, Jain A, Chandra A. Use of calcaneal plates in the treatment of posterior pelvic ring injuries and displaced iliac blade fractures- A case series. J Clin Orthop Trauma 2023; 37:102091. [PMID: 36632341 PMCID: PMC9827374 DOI: 10.1016/j.jcot.2022.102091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/26/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction The operative fixation of pelvic ring injuries and associated acetabulum fractures presents a challenging scenario to most of the orthopaedic trauma surgeons. Current development of anatomically contoured reconstruction (ACR) plates gained popularity in fixing complex pelvic ring fractures. This study was done to assess the functional and radiological outcomes using of lateral wall stainless steel (LWSS) calcaneal plates in posterior pelvic ring injuries and displaced iliac blade fractures. Materials and methods Retrospectively selected eight cases of pelvic ring injuries planned for fixing posterior pelvic instability and iliac blade fractures using LWSS plates. Mean follow-up was 18 months (Range 12-26 months). Results Average time for radiological bony union achieved in 18 weeks (Range 13-22). Seven patients returned to their normal work. Average Majeed score was 60 (Range 50-68). Mean duration of surgery was 160 min (Range 120-200). Conclusion This technique can be routinely used as supplementary fixation for posterior pelvic ring instability and iliac blade fractures. LWSS calcaneal plates showed no screw breakage or implant failure. Further this technique was cost effective in developing countries with limited resources.
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Affiliation(s)
- Zakir Hussain
- Department of Orthopaedics, SMS Medical College, Jaipur, Rajasthan, India
| | | | - Amit Jain
- Department of Orthopaedics, SMS Medical College, Jaipur, Rajasthan, India
| | - Abhishek Chandra
- Department of Trauma Surgery, AIIMS Rishikesh, Uttarakhand, India
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Three-dimensional morphological analysis of quadrilateral plate fragments in associated both-column acetabular fractures. Skeletal Radiol 2022; 51:2175-2184. [PMID: 35503105 DOI: 10.1007/s00256-022-04068-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether the fracture morphology of quadrilateral plate (QP) fragments is associated with the anterior and posterior columns in associated both-column (ABC) fractures. MATERIALS AND METHODS Three-dimensional computed tomography data of 100 ABC fractures treated at our hospital from August 2016 to August 2019 were retrospectively analyzed using Mimics and 3-matic software. The distribution of fracture lines was described using the fracture mapping technique. RESULTS One fragment presented on the QP was confirmed in 88% of the patients. The QP fragments' fracture lines were divided into the anterior oblique (AO), superior posterior oblique (SPO), and mid-posterior oblique (MPO) lines, occurring in 100, 86, and 8 cases, respectively. AO lines were distributed along the arcuate line. SPO lines were continuations of the AO lines, which were distributed to the posterior column from the greater sciatic notch to the lesser sciatic notch. MPO lines were involved in the QP's central area. A simple fracture was found at the proximal AO and SPO lines in 80% and 86% of all displaced fractures, respectively. AO lines distal to the superior rim of the acetabula were confirmed to be comminuted fractures in 32% of all cases. CONCLUSIONS In ABC fractures, there was only one QP fragment in nearly 90% of all cases. The QP fractures were mainly present in the QP's peripheral area. More than 80% of the fracture patterns on the cephalic side of the QP were simple. The reduction and internal fixation of QP fractures in ABC fractures should be in the cephalic region.
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Zhou XF, Gu SC, Zhu WB, Yang JZ, Xu L, Fang SY. Quadrilateral plate fractures of the acetabulum: Classification, approach, implant therapy and related research progress. World J Clin Cases 2022; 10:412-425. [PMID: 35097066 PMCID: PMC8771372 DOI: 10.12998/wjcc.v10.i2.412] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/29/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
The quadrilateral plate (QP) is an essential structure of the inner wall of the acetabulum, an important weight-bearing joint of the human body, which is often involved in acetabular fractures. The operative exposure, reduction and fixation of QP fractures have always been the difficulties in orthopedics due to the special morphological structure and anatomical features of the QP. Fortunately, there have been many effective methods and instruments developed for QP exposure, reduction and fixation by virtue of the combined efforts of numerous orthopedists. At the same time, each method presents with its own advantages and disadvantages, resulting in different prognoses. It is necessary to have a thorough understanding of the anatomy, radiology and fixation techniques of the QP in terms of patient prognosis optimization. In this paper, the anatomical features, definition and classification of QP, operative approach selection, implant internal fixation methods and efficacy were reviewed.
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Affiliation(s)
- Xue-Feng Zhou
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
- Graduate School, Wannan Medical College, Wuhu 241000, Anhui Province, China
| | - Si-Chao Gu
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
| | - Wan-Bo Zhu
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
| | - Jia-Zhao Yang
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
| | - Lei Xu
- Department of Traumatic Orthopedics, The First Affiliated Hospital of USTC, Hefei 230001, Anhui Province, China
| | - Shi-Yuan Fang
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
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Ciolli G, De Mauro D, Rovere G, Smakaj A, Marino S, Are L, El Ezzo O, Liuzza F. Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients. BMC Musculoskelet Disord 2021; 22:1060. [PMID: 34969392 PMCID: PMC8717694 DOI: 10.1186/s12891-021-04908-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
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 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 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 The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.
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Affiliation(s)
- Gianluca Ciolli
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A, Gemelli IRCCS Largo Agostino Gemelli, 8, Rome, Italy.
- Università Cattolica del Sacro Cuore, Rome, Italy.
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Verma S, Agrawal A, Choudhary R, Venishetty N. Management of quadrilateral plate fractures: An up to date. JOURNAL OF ORTHOPEDICS, TRAUMATOLOGY AND REHABILITATION 2021. [DOI: 10.4103/jotr.jotr_26_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pires RE, Giordano V, Boni G, Campos TVO, Lopes MTC, de Andrade MAP. Expanding the indications for calcaneal plates beyond foot fractures: a technical trick and case series. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2020; 31:275-282. [PMID: 32809148 DOI: 10.1007/s00590-020-02757-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/01/2020] [Indexed: 11/30/2022]
Abstract
Although non-locking calcaneal plates are designed to treat calcaneal fractures, they present some interesting characteristics that justify using them beyond their current application in fractures of the foot. Calcaneal plates are malleable, have an increased footprint area for fracture containment or buttressing, and present several hole options for screw placement in different trajectories, thereby providing proper fixation even in comminuted fracture patterns. The aim of this study is to describe the unconventional use of calcaneal plates in the orthopaedic trauma scenario.
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Affiliation(s)
- Robinson E Pires
- Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efegênia, Belo Horizonte, MG, Brazil.
| | - Vincenzo Giordano
- Serviço de Ortopedia e Traumatologia Professor Nova Monteiro - Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil
| | - Guilherme Boni
- Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Tulio Vinicius Oliveira Campos
- Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efegênia, Belo Horizonte, MG, Brazil.,Serviço de Ortopedia e Traumatologia. Hospital Metropolitano Célio de Castro, Belo Horizonte, MG, Brazil
| | - Marcos Tadeu Caires Lopes
- Serviço de Ortopedia e Traumatologia. Hospital Metropolitano Célio de Castro, Belo Horizonte, MG, Brazil
| | - Marco Antônio Percope de Andrade
- Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efegênia, Belo Horizonte, MG, Brazil
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Wu H, Shang R, Cai X, Liu X, Song C, Chen Y. Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-Screw System. Orthop Surg 2020; 12:488-497. [PMID: 32162455 PMCID: PMC7189029 DOI: 10.1111/os.12648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate–screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. Methods A total of 32 patients with acetabular fractures, selected between January 2009 and March 2016, were managed by DAPSQ with “quadrilateral screws” through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow‐up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss. Results Of these 32 consecutive patients, 19, 9, and 4 were classified as both columns, anterior column posterior hemi‐transverse, and T‐shaped fractures, respectively, and with an average of 47 months’ follow‐up. Anatomic reduction was obtained in 19 cases (59%), imperfect reduction in 9 cases (28%), and poor reduction in 4 cases (13%). The modified Merle d'Aubigné scores were excellent in 15 cases (47%), good in 13 cases (41%), fair in 2 cases (6%), and poor in 2 cases (6%). Three cases sustained temporary lateral femoral cutaneous nerve injuries. One patient had a superficial wound infection that resolved after debridement. Five patients had posttraumatic arthritis; one of them underwent total hip arthroplasty at 46 months. No cases had quadrilateral screws entering the hip joint. Conclusion The use of DAPSQ with quadrilateral screws is an effective and safe choice for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.
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Affiliation(s)
- Haiyang Wu
- Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan Clinical Medicine College of Southern Medical University, Wuhan, China
| | - Ranran Shang
- Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan, China
| | - Xianhua Cai
- General Hospital of Central Theater Command, Wuhan Clinical Medicine College of Southern Medical University, Wuhan, China
| | - Ximing Liu
- Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan, China
| | - Chengjing Song
- Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan, China
| | - Yanzhao Chen
- Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan, China
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