Determining Stability in Posterior Wall Acetabular Fractures

Firoozabadi, Reza; Spitler, Clay A.; Schlepp, Calvin; Hamilton, Benjamin; Agel, Julie; Routt, Milton “Chip”; Tornetta, Paul

doi:10.1097/bot.0000000000000354

Cited by 34 publications

(29 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the image of the fractured acetabulum is sometimes covered by the femoral head, especially when the hip is dislocated. Using the software, the femoral head can be eliminated, and complete evaluation of the acetabular fracture pattern can be achieved [15–17]. Posterior wall fragment size is one of the risk factors for the residual instability of hip joint after closed reduction [17].…”

Section: Discussionmentioning

confidence: 99%

“…Using the software, the femoral head can be eliminated, and complete evaluation of the acetabular fracture pattern can be achieved [15–17]. Posterior wall fragment size is one of the risk factors for the residual instability of hip joint after closed reduction [17]. However, there was no uniform method to calculate the percentage of posterior wall involvement.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

Hung

Chou

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Background and Purpose. Hip dislocation combined with acetabular fracture remains a challenging condition for orthopedic surgeons. In this study, we utilized a computer-assisted simulation and three-dimensional (3D) printing technology to treat patients with hip dislocation combined with acetabular fracture. We hypothesized that the 3D printing-assisted method would shorten the internal fixation time and surgical time. Methods. We retrospectively reviewed 16 patients diagnosed with traumatic posterior dislocation of hip combined with acetabular fractures and treated with plate fixation from September 2013 to August 2017. Patients were divided into two groups: (1) traditional method and (2) 3D printing groups. In the traditional method group, the plates were contoured during the surgery, whereas in the 3D printing group, the patient’s pelvic computed tomography image was transformed to the 3D medical image software for processing preoperatively. The fracture reduction was simulated by the computer. Thereafter, the 1:1 scale 3D printing model was used to design the surgical plan and contour patient-specific plates preoperatively. Results. The internal fixation time was significantly shorter in the 3D printing group than in the traditional method group (-33 min, P<0.05). The mean operative time was shorter than that in the traditional method group (-43 min). However, blood loss and postoperative radiograph results were similar between the groups. The complication rate was lower in the 3D printing group (2/7) than in the traditional method group (5/9). Interpretation. Computer-assisted simulation with 3D printing technology is a more efficient method for treating hip dislocation combined with acetabular fractures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

Hung

Chou

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…These types of posterior wall fractures are all caused by the impact of the femoral head on the posterior wall of the acetabulum posteriorly 3 . Previous studies in the literature have adequately reported the treatment and prognosis of these types of posterior wall fractures, suggesting that anatomical reduction and internal fixation are key to achieving good outcomes, unless the hip remains stable 4,5 . However, in our clinical work, we found that both-column acetabular fractures are sometimes associated with posterior wall fractures (Fig.…”

Section: Introductionmentioning

confidence: 99%

Morphological Characteristics of Posterior Wall Fragments Associated with Acetabular Both-column Fracture

Tian

Chen

Yin

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Treatment of both-column fractures with posterior wall involvement is still a controversial topic. This type of posterior wall fracture is different from isolated acetabular posterior wall fracture (AO/OTA62-A1). The aim of this study is to compare the morphology of the posterior wall fragments of these two fracture patterns using computed tomography (CT) scans. All measured data were compared, and the differences between the groups (acetabular both-column fractures with posterior wall involvement were included in group A, and acetabular isolated posterior wall fractures were included in group B) were significant (P ≤ 0.05), including the direction angle, displacement, articular surface-posterior cortex ratio and articular surface area of the fracture fragment. The intraclass correlation coefficient of the measurements included inter-observer (ICC = 0.860) and intra-observer (ICC = 0.853). The morphology of the posterior wall fragments associated with both-column fractures is significantly different from that in isolated acetabular posterior wall fractures, and the treatment of the posterior wall fragment involved in both-column fractures of the acetabulum should be different from that of isolated acetabular posterior wall fractures.

show abstract

“…The influence of acetabular version and impingement may be also closely involved in how challenging the determination of hip stability can be in patients with posterior wall acetabular fractures [9]. Acetabular retroversion and FAI may be related to the dislocation of unstable patterns with small fragments (wall sizes less than 20%) [10].…”

Section: Discussionmentioning

confidence: 99%

Morphological abnormalities of the hip in acetabular fractures

Rı́o

Garín

Acuña³

et al. 2020

Trauma Case Reports

View full text Add to dashboard Cite

Poor prognosis factors in surgical treatment of acetabular fracture-dislocations have been well established but there is little information about how morphological abnormalities of the hip may affect the surgical outcome. Hip anatomy has a wide range of variations. Morphological abnormalities of the hip can also be observed in patients with acetabular fractures. We present a case of a complication in a patient with a complex acetabular fracture, acetabular retroversion and femoroacetabular impingement. A 31-year old male patient was transferred to our trauma center following a high speed road traffic accident. Trauma series CT revealed cerebral contusion, subdural hematoma, aortic dissection and a left transverse plus posterior wall acetabular fracture. The left hip was reduced and the acetabular fracture was treated with a Kocher Langenbeck approach in prone position. The pelvic X- ray evidenced an anatomic reduction and signs of acetabular retroversion with positive posterior wall sign and crossover sign. CT scan evidenced increased alpha angle in the femoral head neck junction. During the follow up, 2 months after the acetabular fixation, patient suffered a posterior left hip dislocation and a total cementless hip arthroplasty was performed. Patients with acetabular retroversion and femoroacetabular impingement (CAM lesion) may be at risk of posterior dislocation. The influence of acetabular version and impingement may be also closely involved in how challenging the determination of hip stability can be in patients with posterior wall acetabular fractures. Acetabular retroversion and FAI may be related to the dislocation of unstable patterns with small fragments (wall sizes less than 20%). In this case postoperative precautions were not enough. We believe capsular reattachment with anchors and bracing may be useful in these selected cases. As these patients are not candidates for retroPAO (the recommended treatment for acetabular retroversion) maybe arthroscopic anterior wall riming and CAM resection should be performed at an early stage to decrease or avoid fulcrum.

show abstract

Determining Stability in Posterior Wall Acetabular Fractures

Abstract: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 34 publications

References 13 publications

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

Morphological Characteristics of Posterior Wall Fragments Associated with Acetabular Both-column Fracture

Morphological abnormalities of the hip in acetabular fractures

Contact Info

Product

Resources

About