Application Of Acetabular Hook Plate In The Treatmentcox Complex Acetabular Fractures

Objective : To explore the value of acetabular hook plate in the treatment of complex acetabular fractures.Methods:Data of 13 patients with complex acetabulum treated with acetabular hook plate from January 2015 to September 2017 were retrospectively analyzed,including 11 males and 2 females.Age: 23-64(40.07±11.13);Time between injury and surgery 5-19(8.38±3.93)d;According to Letournel--Judet classification,there were 8 cases of unilateral double-column fractures,including 1 case of comminuted posterior wall fracture,2 cases of anterior column with posterior transverse fracture,2cases of t-type fracture,and 1 case of transverse wall fracture.Most of the patients were combined with other fractures,and all the 13 cases were combined with square fracture.Nine patients underwent the ilioinguinal approach,3 patients underwent the modified Stoppa approach,and 1 patient underwent the ilioinguinal + k-l approach,and acetabular hook plate was used for reduction and fixation.Postoperative Matta imaging evaluation criteria were used to evaluate the fracture reduction,and Merle d’aubigne was used.Postel score assessed hip function.Results : All the 13 patients were followed up for 12-24(20.00±3.26)months.The average operation time was 223 min,and the average blood loss was781 ml.All the 13 patients’ fractures were healed,and the healing time was 3-6 months(3.9±0.997).Postoperative fracture reduction was evaluated according to Matta standard,9 cases of anatomical reduction,2 cases of satisfactory reduction,2 cases of acceptable reduction,excellent and good rate of 84.62%.In the last follow-up,hip joint function was scored 14-18(17.15±1.41)by Matta modified Merle d ’aubigne and Postel scoring system,among which 8 cases were excellent,3 cases were good,and 2 cases were acceptable,with an excellent and good rate of 84.62%(11/13).One patient had fat liquefaction on the 4th day after surgery and wound healing 10 days after dressing change.One patient suffered from traumatic hip arthritis of the affected limb 12 months after surgery.After symptomatic treatment,the patient’s conditionremained stable and did not worsen during 2 years of postoperative follow-up.Conclusion:Through the analysis of the clinical effect of acetabular hook plate in the treatment of complex acetabular fractures,this plate can be used for the treatment of complex acetabular fractures through a single anterior approach and multi-directional fixation,especially the reduction and fixation of the comminuted fracture in the square area,which is safe,effective and has a satisfactory clinical effect.This study is a preliminary applied study,and further studies are needed to compare the efficacy of this method with new surgical approaches and internal fixation implants.