Acta Ortopédica Mexicana

Ramos E, Torres A, Callejas E, Micha M, Jorba P, Farah A
Infrapectineal plate for repair with minimal invasion of quadrilateral blade acetabular fractures: description new implant and paramedial access
Acta Ortop Mex 2018; 32 (3)

Language: Español
References: 16
Page: 118-125
PDF: 249.84 Kb.

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ABSTRACT

Introduction: Quadrilateral plate fractures are the most difficult to reduce and fix. Different techniques have been developed for quadrilateral plate osteosynthesis. The objective of this work was to create an implant and a novel approach to simplify and improve acetabular fracture osteosynthesis. Material and methods: A total of 83 patients were studied. Pelvic CT scan images of both acetabula were measured at the proximal and distal posterior column. Implant length, diameters and morphological characteristics were determined. The anatomical features of a novel surgical approach are described. The paramedian approach was performed on a cadaveric specimen to determine its anatomical safety. Results: The screws measured 20 × 6 × 8 mm (length × core diameter x head diameter), with internal threads of 4.5 mm. The Kolmogorov-Smirnov (Lilliefors) test was used, where p had to be › 0.05. Plates were previously determined to be 10 mm wide and 3 mm thick, of variable length. Instruments were developed to surmount difficulties. Discussion: This new procedure and implant could make the repair of acetabular fractures easier and offers several advantages. Clinical trials are needed to assess the benefits of this proposal. The newly described method can allow acetabular fracture osteosynthesis to be performed safely, avoid iatrogenic injury to anatomical structures and achieve better results.


Key words: Quadrilateral plate, posterior column, paramedian approach, minimally invasive, new method, osteosynthesis.