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Management of geriatric acetabular fractures:Contemporary treatment strategies

World Journal of Clinical Cases 2024年第13期12卷 2151-2156页

作者： Theodoros Tosounidis Byron Chalidis Academic Department of Orthopaedic Surgery Heraklion University HospitalUniversity of CreteGreeceHeraklion 71500Greece 1^(st)Department of Orthopaedic School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 57010Greece

acetabular fractures in the geriatric population are typically low-energy fractures resulting from a fall from standing height.Compromised bone quality in the elderly,as well as this population’s concomitant medical comorbidities,render the management of such fractures challenging and controversial.Non-operative management remains the mainstay of treatment,although such a choice is associated with numerous and serious complications related to both the hip joint as well as the general condition of the patient.On the other hand,operatively treating acetabular fractures(e.g.,with osteosynthesis or total hip arthroplasty)is gaining popularity.Osteosynthesis can be performed with open reduction and internal fixation or with minimally invasive techniques.Total hip arthroplasty could be performed either in the acute phase combined with osteosynthesis or as a delayed procedure after a period of non-operative management or after failed osteosynthesis of the acetabulum.Regardless of the implemented treatment,orthogeriatric co-management is considered extremely crucial,and it is currently one of the pillars of a successful outcome after an acetabular fracture.

关键词： acetabular fractures Geriatric fractures Fracture fixation Total hip arthroplasty Mortality Morbidity

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A novel anatomical self-locking plate fixation for both-column acetabular fractures

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Chinese Journal of Traumatology 2022年第6期25卷 345-352页

作者： Ming Li Shuai-Yi Wang Jing-Wei Xiao Department of Traumatic Orthopaedics The Medical College of Ningbo University Affiliated Ningbo No.6 HospitalNingbo 315040Zhejiang ProvinceChina

Purpose:To compare the stability of the posterior anatomic self-locking plate(PASP)with two types of popular reconstruction plate fixation,i.***.double reconstruction plate(DRP)and cross reconstruction plate(CRP),and to explore the influence of sitting and turning right/left on implants.Methods:PASP,DRP and CRP were assembled on a finite element model of both-column fractures of the left acetabulum.A load of 600 N and a torque of 8 N·m were loaded on the S1 vertebral body to detect the change of stress and displacement when sitting and turning right/left.Results:The peak stress and displacement of the three kinds of fixation methods under all loading conditions were CRP>DRP>PASP.The peak stress and displacement of PASP are 313.5 MPa and 1.15 mm respectively when turning right;and the minimal was 234.0 Mpa and 0.619 mm when turning left.Conclusion:PASP can provide higher stability than DRP and CRP for both-column acetabular fractures.The rational movement after posterior DRP and PASP fixation for acetabular fracture is to turn to the ipsilateral side,which can avoid implant failure.

关键词： acetabular fractures Internal fixation Posterior anatomic self-locking plate(PASP) Biomechanics Stability

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Three-dimensional printing combined with open reduction and internal fixation versus open reduction and internal fixation in the treatment of acetabular fractures:A systematic review and meta-analysis

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Chinese Journal of Traumatology 2021年第3期24卷 159-168页

作者： Dong-Peng Tu Yi-Kang Yu Zhen Liu Wen-Kai Zhang Xin Fan Chao Xu The Second Clinical Medical College Zhejiang Chinese Medical UniversityHangzhou310053China Zhejiang Chinese Medical University Hangzhou310053China Department of Orthopaedic the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou310005China

Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complic

关键词： Three-dimensional printing acetabular fractures Open reduction and internal fixation Meta-analysis

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