科研之友
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摘要
Objective: To evaluate the effect of anterior special shaping titanium plate with Square District screws combined with posterior column lag screw internal fixation in the treatment of involving the quadrilateral area of acetabular fracture biomechanical stability and clinical effect. Method: The finite element modeling software to establish a double column titanium plate (a), simple anterior special shaping titanium plate and quadrilateral screws (b) and anterior special shaping titanium plate with Square District screws combined with posterior column lag screw (c) internal fixation in the treatment of involving the quadrilateral area of acetabular fracture model. Three dimensional finite element analysis of the 5 kinds of standard gait. Secondly, 21 cases of acetabular fractures involving the square region from March 2010 to May 2013 were retrospectively analyzed, including 13 males and 8 females, aged from 19 to 65 years, with an average age of 41.2 years. The use of single iliac groin approach, the use of titanium plate combined with square area screw fixation for the treatment of internal fixation. Results: Three in all kinds of gait, 1 kinds of internal fixation and normal model were compared, and the average displacement of each node in the fracture line was C < B < normal model < A. The statistical analysis showed that in 22 degrees of hip flexion and extension degrees 12 and 14 degrees, the differences between no significant (P > 0.05) and in 18 degrees of hip flexion and extension of 4 degrees, the differences between fixed A and B, A and C only with statistical significant difference (P < 0.05). 21 patients were followed up for an average of 21.4 months (7 to 38 months). According to Matta criteria, the quality of acetabular fracture reduction was evaluated: anatomic reduction of 14 cases, satisfactory reduction in 6 cases, and unsatisfactory reduction in 1 case. The function of hip joint was evaluated by D Aubign's-Postel function score: 12 cases were excellent, 5 cases were good, 3 cases were poor, 1 case was poor, the excellent and good rate was 81%. Complications: 2 cases of lateral femoral cutaneous nerve palsy, 1 cases of heterotopic ossification, 2 cases of traumatic arthritis, the incidence rate was 23.8%. Conclusion: Anterior special shaping titanium plate with Square District screws combined with posterior column lag screw internal fixation in the treatment of involving the quadrilateral area of acetabular fractures with good biomechanical stability. It has the advantages of less trauma, reliable fixation, low incidence of complications, and satisfactory clinical effect. It is a feasible method to deal with this kind of acetabular fractures.
- 出版日期2016
- 单位中国人民解放军广州军区武汉总医院
