The Clinical And Basic Comparative Study Of Treatment Of Acetabulum Fracture By Three Internal Fixatior

Backgroud:Acetubular fracture is one of the most dramtic traumas, the kinds of acetubular fracture are comple and hard to open reduction and internal fixation. The effects of acetubular fracture go together with open reduction and internal fixation. The ideal device for treatment of acetubular fracture bases on the satisfactory effects. The research of literatures home and abroad focus on comparing the effects and its influencing factors, imaging techniques, operation complications, and so on. However, associations between biomechanical study of acetubular fracture are less well established.Objective:To study the biomechanical and compare the effects of three internal fixation methods for the acetubular fractures retrospectively and to provide pharmaceutical services for clinicians.Methods:120 patients with acerubular fractures from May 2011 to Oct.2013 in our hospital were divided into three groups with 40 patients each, reconstruction plate fixation Group, Locked-plate fracture-fixation Group and memory-alloy Group. Follow-up of the effects of three internal fixation methods for the acetubular fractures should be emphasized by X-ray and clinical standard for Matta system within 3-24 months after surgery. To choose the acetubular fracture of bodies,simulating to an in vitro human cadaveric biomechanical study for determine the distribution of stresses, the contact area of acetabular bone and caput femoris, the horizontal displacements of fractures and the distribution of stresses for around acetabular bone.Results:The time of operation of reconstruction plate fixation Group was (223.27±34.82) min, The time of operation of Locked-plate fracture-fixation Group was (236.12±41.22) min and the time of operation of memory-alloy Group was (182.62±29.17) min. The time of operation for three groups was was statistically significant(t=6.494, P<0.05). The time of operation of memory-alloy Group was the shortest of three groups.The bleeding of operation of reconstruction plate fixation Group was (838.28±59.38) ml, The bleeding of operation of Locked-plate fracture-fixation Group was (938.20±63.25)ml and the bleeding of operation of memory-alloy Group was (549.17±23.48) ml. The bleeding of operation was was statistically significant(t=7.372, P<0.05). The bleeding of operation of memory-alloy Group was the least of three groups. The resetting excellent rate of reconstruction plate fixation Group was 80.00%, the resetting excellent rate of operation of Locked-plate fracture-fixation Group 87.50% and the resetting excellent rate of memory-alloy Group was 97.50%. The resetting excellent rate three groups was statistically significant(x2=5.938, P<0.05). The resetting excellent rate of memory-alloy Group was the highest of three groups. The pass rate of reconstruction plate fixation Group by follow-up for 3-24 months after surgery was 75.00%, the pass rate of operation of Locked-plate fracture-fixation Group follow-up for 3-24 months after surgery was 87.50% and the resetting excellent rate of memory-alloy Group follow-up for 3-24 months after surgery was 97.50%. The pass rate of three groups by follow-up for 3-24 months after surgery was statistically significant (x2=13.481, P< 0.05). The pass rate of memory-alloy Group follow-up for 3-24 months after surgery was the highest of three groups. There were no statistically significant for the compressive loads of 200N、400N、600N.800N and 1000N of the distribution of stresses in an vitro human cadaveric biomechanical study for determine for three internal fixation methods for the acetubular fractures(P<0.05). The effects of the memory-alloy Group were better than the other two groups of the compressive loads from 200N to1000N. The contact area of acetabular bone and caput femoris of three groups was statistically significant (t=4.129, P <0.05) and the horizontal displacements of fractures of memory-alloy Group was the biggest of three groups.The horizontal displacements of fractures of three groups was statistically significant (t=3.133, P<0.05) and the horizontal displacements of fractures of memory-alloy Group was the smallest of three groups.Conclusion:The memory-alloy is a good kind for internal fixation of acetubular fracture. It has good mechanical property.It is safe and reliable. The reliability of memory-alloy is the best of the reconstruction plate fixation and Locked-plate fracture- fixation, so it could be applicable to clinic.