The study of broken quadrilateral surface in fractures of the acetabulum

Prasartritha, Thavat; Chaivanichsiri, Paskorn

doi:10.1007/s00264-013-1845-1

Cited by 20 publications

(10 citation statements)

References 36 publications

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“…We have in this study there were males 75.5% and females 24.5%;Gänsslen et al( 16) Zinghi et al [17] found similar results as they reported that the majority of patients were men. There were 28.5% fell from height and 71.4 % had car accidents; Parasartritha and Chaivanichsiri [18] reported 14.7 % fell down and 85.3 % due to Road Traffic Accident (RTA) in their study however their associated injuries were higher as they were reported 60.3 % associated injuries. Gänsslen et al [16] and Praveen et al, [19] had similar data to our study as they reported 78.9 % RTA and 21.1 % fell from heights, and associated injuries in 57.9 % of their series.…”

Section: Discussionmentioning

confidence: 86%

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Clinical Outcome of Posterior Wall Acetabular Fractures Treated by Open Reduction and Internal Fixation

Abdel-Ghany¹

2021

GJOR

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Background: Posterior wall acetabular fractures are the most common type of fracture acetabulum. Surgical treatment is the standard solution for displaced posterior acetabular wallfractures.Study Design: This retrospective study evaluatesclinical and radiologic outcomes of open reduction and internal fixation in patients with posterior wall acetabular fractures.Patients and methods: This study includes49 cases (37 males (75.5%) and 12 females (24.5%)), average age was 32.1 Years.All patients were admitted in both hospitals andunderwent surgical treatment of posterior wall acetabular fractures. All patients treated at Al-Zahraa University Hospital and Heliopolis hospitalbetweenMarch2011andJanuary2019. All patients had history of fall from height or car accident.Result: Clinicaloutcomes were assessed by Modified Merl d' Aubejan Score (MMS) after surgery at the time of the study and evaluation of general condition and return to previous activities. The final clinical outcome was excellent in 32 cases (65.3%), good in 13 cases (26.5%), fair in 2 cases (4.1%) and poor in 2 cases (4.1%). Finally, both excellent and good outcome were considered satisfactory 45 cases (91.8%) and both fair and poor outcome were considered as unsatisfactory 4 cases(8.2%). Cases with satisfactory outcome had less associated injury and younger in age. Five cases (10.2 %) had superficial infection that treated by antibiotics and dressing,one case (2.05%) had sciatic nerve injury and two cases (4.1%)had AVN femoral head were reporte 654kd. Conclusion:posterior wall acetabular fractures had favorable outcome with open reduction and internal fixation. Optimum time for surgery is earlier as possible, however early mobilization is preferred it may depends on the associated injury and treatment of that injuries. At least static exercise should be tried to improve the clinical outcome and minimize the complication of morbidity.

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Section: Discussionmentioning

confidence: 86%

“…According to Modified Merle d' Aubigne score [8], Stability score were ranged from (5-6) with mean score 5.9 SD± 0.2; pain score ranged from (3-6) with mean 5.7 SD±0.6 and ability to walk score ranged from2-6 with mean score 5.6 SD±0.5. The final results mean score 17.2 SD±1.2 and ranged from [11,18] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Clinical Outcome of Posterior Wall Acetabular Fractures Treated by Open Reduction and Internal Fixation

Abdel-Ghany¹

2021

GJOR

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“…Most should agree that anatomic reduction of weight bearing surface and concentric reduction of the hip joint is essential for long-term satisfactory results [2]. The type and nature of the acetabular fracture substantially influence which approach is used [1, 3].…”

Section: Introductionmentioning

confidence: 99%

Supra-ilioinguinal versus modified Stoppa approach in the treatment of acetabular fractures: reduction quality and early clinical results of a retrospective study

Yao

Chen

et al. 2019

J Orthop Surg Res

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BackgroundTo compare the efficacy of the operative techniques, complications, reduction quality and hip functional recovery by using the supra-ilioinguinal approach and the modified Stoppa approach for the management of acetabular fractures.MethodsA consecutive cohort of 60 patients from September 2014 to October 2017 with displaced acetabular fractures involving the quadrilateral plate were treated operatively with supra-ilioinguinal approach (group A) and modified Stoppa approach (group B), respectively. There were 36 patients in group A and 24 patients in group B. The surgical details, complications, radiographic and clinical results were recorded. The quality of reduction was assessed by measuring the residual step and gap displacement of postoperative CT with a standardized digital method.ResultsThe complications, reduction quality (gaps and steps) and hip function recovery had no significant statistical difference in approaches. The mean operative time was shorter and the mean intraoperative haemorrhage was less in group A. There were statistical differences in the operative time (P = 0.025) and intraoperative haemorrhage (P = 0.003) between the supra-ilioinguinal approach and the modified Stoppa approach.ConclusionCompared to the modified Stoppa approach, the supra-ilioinguinal approach provides a closer visualization to the quadrilateral plate, the operative time was shorter and the intraoperative haemorrhage was clearly less. It is at least equal to or could be a better choice to deal with complicated acetabular fractures especially involving the quadrilateral plate and the anterior one third of the iliac bone.

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“…For example, it has been reported that inexperienced readers have an accuracy of only 11% when diagnosing these fractures on the basis of radiographs, a percentage that is no greater than the hazard ratio 6 , 7 , and that general orthopaedists and senior orthopaedic residents have an accuracy of <65% 7 , 8 . Considering these results, some authors have tried to simplify the analysis of acetabular fractures by offering new classification systems or diagnostic algorithms 9 - 13 . Some authors have introduced relatively complex redefinitions of acetabular landmarks that do not result in a real clarification of the Letournel classification 9 , 10 .…”

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confidence: 99%

“…Considering these results, some authors have tried to simplify the analysis of acetabular fractures by offering new classification systems or diagnostic algorithms 9 - 13 . Some authors have introduced relatively complex redefinitions of acetabular landmarks that do not result in a real clarification of the Letournel classification 9 , 10 . Other authors have opted for the development of a new classification system involving 3 main categories with subcategories 11 , 13 .…”

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confidence: 99%

A New, Easy, Fast, and Reliable Method to Correctly Classify Acetabular Fractures According to the Letournel System

Riouallon

Sebaaly

Upex

et al. 2018

JBJS OA

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Background:Accurate classification of acetabular fractures remains difficult. To aid in the classification of acetabular fractures and to aid in teaching, our department developed a diagnostic algorithm that involves the use of 1 standardized 3-dimensional reconstruction of a computed tomography (CT) scan (an exopelvic view without the femoral head) with 8 anatomical landmarks. The algorithm was integrated into a smartphone application (app). The main objective of this study was to test the efficacy of this algorithm and smartphone app.Methods:Fourteen reviewers (3 experts, 3 fellows, 3 residents, and 5 novice reviewers) evaluated a set of 35 CT scans of acetabular fractures in 2 phases. During the first phase, the scans (including axial 2-dimensional views and 3-dimensional (3D) multiplanar reconstruction views) were assessed by each reviewer twice, with an interval of 4 weeks between the readings to decrease recall bias. During that phase, the reviewers were provided with a diagram of the Letournel classification system with no guidelines for interpretation. During the second phase, performed 4 weeks after the first phase, 1 standardized 3D reconstruction (an exopelvic view without the femoral head) was reviewed twice, with an interval of 4 weeks between the readings. During that phase, the reviewers used the smartphone app. The primary outcome was the accuracy of classification. Interobserver reliability, reading time, and time needed for accurate classification were noted.Results:The accuracy of fracture classification was 64.5% when the standard method of analysis was used and 83.4% when the app was used (p < 0.001). Improvement was noted in all groups, with the expert group showing the least improvement (88.6% to 97.2%, p = 0.04) and the novice group showing the most improvement (42.0% to 75.5%, p < 0.001). Furthermore, use of the app greatly increased the accuracy of classification of complex fractures. The average reading time was 71.8 minutes when the standard method was used and 37.4 minutes when the app was used. The interobserver reliability improved in all groups to an excellent reliability (interclass correlation coefficient [ICC] > 0.79).Conclusions:The Letournel classification system is difficult to understand and to learn but remains the only system guiding the surgical strategy for acetabular fractures. The impact of diagnostic algorithms is debatable. The most important finding of the present study is the high accuracy for inexperienced groups when the app was used. Another important finding is the high reliability of this method for the diagnosis of complex acetabular fractures.

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The study of broken quadrilateral surface in fractures of the acetabulum

Cited by 20 publications

References 36 publications

Clinical Outcome of Posterior Wall Acetabular Fractures Treated by Open Reduction and Internal Fixation

Clinical Outcome of Posterior Wall Acetabular Fractures Treated by Open Reduction and Internal Fixation

Supra-ilioinguinal versus modified Stoppa approach in the treatment of acetabular fractures: reduction quality and early clinical results of a retrospective study

A New, Easy, Fast, and Reliable Method to Correctly Classify Acetabular Fractures According to the Letournel System

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