J Korean Hip Soc.  2011 Jun;23(2):131-136. 10.5371/jkhs.2011.23.2.131.

Comparative Results of Acetabular Both Column Fracture According to the Fixation Method

• Lee KJ
• Min BW
• Son ES
• Seo HJ
• Park JH

• KMID: 2190724
• DOI: http://doi.org/10.5371/jkhs.2011.23.2.131

Abstract

PURPOSE
We wanted to compare the clinical and radiological results of surgical treatment of acetabular both column fracture according to the fixation method.
MATERIALS AND METHODS
Between 1986 and 2008, 55 patients who underwent surgical treatment for acetabular both column fracture were clinically and radiologically evaluated after a minimum follow-up of one year. Of 55 patients, 29 cases were operated with a cerclage wire or cable (group I) and 26 cases were operated with a plate and screw (group II). The surgical approach, the intra- and post-operative complications and the reduction quality were compared between the two groups. The clinical and radiological results were analyzed according to the criteria reported by Matta.
RESULTS
There were 14 (48.3%)/20 (76.9%) cases of anatomical reduction, 12 (41.4%)/6 (23.1%) cases of imperfect reduction, 1/0 case of poor reduction and 2/0 cases of surgical secondary incongruence, respectively. Thirty three patients of 34 anatomically reduced patients showed excellent clinical results and the anterior and posterior combined approach was frequent in group I. There were no differences between the two groups for the complications, although intraoperative complication was more frequent in group II and postoperative complication was more frequent in group I.
CONCLUSION
The clinical and radiological results of surgical treatment in patients with both column fracture were satisfactory in both groups. However, the concerns related to the surgical approach and complications will require a randomized prospective study.

Keyword

Acetabulum; Both column fracture; Surgical treatment; Fixation method

MeSH Terms

Acetabulum
Follow-Up Studies
Humans
Intraoperative Complications
Postoperative Complications

Figure

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  Fig. 1 (A) Preoperative radiograph of 42-year-old male shows displaced acetabular both column fracture. (B) Postoperative radiograph shows an anatomical reduction of fracture site with wires. (C) Radiograph obtained 17 years postoperative shows congruent and stable hip joint.

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  Fig. 2 (A) Preoperative radiograph of 36-year-old male shows disruption of iliopectineal and ilioischial line. (B) Postoperative radiograph shows an anatomical reduction of the both column fracture with plate and screws. (C) Radiograph obtained 5 years after surgery shows congruent and stable hip joint.

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