A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study
Abstract Background Surgical treatment of acetabular fractures involving a quadrilateral plate is a challenge to orthopedic surgeons. We have developed a novel fixation technique using a specially shaped reconstruction plate combined with several buttress screws of a quadrilateral plate which was al...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-05-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01659-w |
| _version_ | 1817993125101043712 |
|---|---|
| author | Haiyang Wu Ranran Shang Ximing Liu Chengjing Song Yanzhao Chen Xianhua Cai |
| author_facet | Haiyang Wu Ranran Shang Ximing Liu Chengjing Song Yanzhao Chen Xianhua Cai |
| author_sort | Haiyang Wu |
| collection | DOAJ |
| description | Abstract Background Surgical treatment of acetabular fractures involving a quadrilateral plate is a challenge to orthopedic surgeons. We have developed a novel fixation technique using a specially shaped reconstruction plate combined with several buttress screws of a quadrilateral plate which was also called a dynamic anterior plate-screw system for quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005 (RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, standardized titanium plate (STP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the STP group during the inclusion period (2016–2018) and were matched to 22 cases in our database of the RP group (2008–2016). The primary outcome measures were the quality of reduction and functional outcomes. Intraoperative conditions were also compared. Results Of these 22 consecutive patients in the STP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12 cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12–37). There were no significant differences between the two groups with regard to the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score (P > 0.05). Compared with the RP group, the STP group had a shorter operation time (245.1 min vs. 286.8 min, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3 mL, P = 0.014), and transfusion (780.9 vs. 1256.8 mL, P = 0.035). The complication rate was 18.2% in the STP group, and there was no significant difference compared with the RP group (36.4%) (P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusions The fixation of standardized titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The standardized titanium plate of DAPSQ has the advantages of a short operation time, less intraoperative bleeding, and blood transfusion, and it is worth further promotion and research. |
| first_indexed | 2024-04-14T01:35:39Z |
| format | Article |
| id | doaj.art-59c615cf4a3a41378a6c9388747eb3a5 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T01:35:39Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-59c615cf4a3a41378a6c9388747eb3a52022-12-22T02:19:57ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-05-0115111310.1186/s13018-020-01659-wA novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort studyHaiyang Wu0Ranran Shang1Ximing Liu2Chengjing Song3Yanzhao Chen4Xianhua Cai5Department of Orthopaedic Surgery, General Hospital of Central Theater CommandDepartment of Orthopaedic Surgery, General Hospital of Central Theater CommandDepartment of Orthopaedic Surgery, General Hospital of Central Theater CommandDepartment of Orthopaedic Surgery, General Hospital of Central Theater CommandDepartment of Orthopaedic Surgery, General Hospital of Central Theater CommandDepartment of Orthopaedic Surgery, General Hospital of Central Theater CommandAbstract Background Surgical treatment of acetabular fractures involving a quadrilateral plate is a challenge to orthopedic surgeons. We have developed a novel fixation technique using a specially shaped reconstruction plate combined with several buttress screws of a quadrilateral plate which was also called a dynamic anterior plate-screw system for quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005 (RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, standardized titanium plate (STP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the STP group during the inclusion period (2016–2018) and were matched to 22 cases in our database of the RP group (2008–2016). The primary outcome measures were the quality of reduction and functional outcomes. Intraoperative conditions were also compared. Results Of these 22 consecutive patients in the STP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12 cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12–37). There were no significant differences between the two groups with regard to the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score (P > 0.05). Compared with the RP group, the STP group had a shorter operation time (245.1 min vs. 286.8 min, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3 mL, P = 0.014), and transfusion (780.9 vs. 1256.8 mL, P = 0.035). The complication rate was 18.2% in the STP group, and there was no significant difference compared with the RP group (36.4%) (P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusions The fixation of standardized titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The standardized titanium plate of DAPSQ has the advantages of a short operation time, less intraoperative bleeding, and blood transfusion, and it is worth further promotion and research.http://link.springer.com/article/10.1186/s13018-020-01659-wAcetabular fractureQuadrilateralFracture reductionFixationReconstruction plateModels |
| spellingShingle | Haiyang Wu Ranran Shang Ximing Liu Chengjing Song Yanzhao Chen Xianhua Cai A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study Journal of Orthopaedic Surgery and Research Acetabular fracture Quadrilateral Fracture reduction Fixation Reconstruction plate Models |
| title | A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study |
| title_full | A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study |
| title_fullStr | A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study |
| title_full_unstemmed | A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study |
| title_short | A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study |
| title_sort | novel anatomically pre contoured side specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum a propensity matched cohort study |
| topic | Acetabular fracture Quadrilateral Fracture reduction Fixation Reconstruction plate Models |
| url | http://link.springer.com/article/10.1186/s13018-020-01659-w |
| work_keys_str_mv | AT haiyangwu anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT ranranshang anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT ximingliu anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT chengjingsong anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT yanzhaochen anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT xianhuacai anovelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT haiyangwu novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT ranranshang novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT ximingliu novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT chengjingsong novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT yanzhaochen novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy AT xianhuacai novelanatomicallyprecontouredsidespecifictitaniumplateversusthereconstructionplateforquadrilateralplatefracturesoftheacetabulumapropensitymatchedcohortstudy |