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

Kyung-Jae Lee; Byung-Woo Min; Eun-Seok Son; Hyuk-Jun Seo; Jin-Hyun Park

doi:10.5371/jkhs.2011.23.2.131

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Lee, Min, Son, Seo, and Park: Comparative Results of Acetabular Both Column Fracture According to the Fixation Method

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(2): 131-136.

Published online: 30 June 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.2.131

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

Kyung-Jae Lee, MD, Byung-Woo Min, MD, Eun-Seok Son, MD, Hyuk-Jun Seo, MD, Jin-Hyun Park, MD

Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, Korea.

Address reprint request to Byung-Woo Min, MD. Department of Orthopedic Surgery, School of Medicine, Keimyung University, 194 Dongsan-dong, Jung-gu, Daegu 700-712, Korea. TEL: +82-53-250-7267, FAX: +82-53-250-7205, min@dsmc.or.kr

Received 15 January 2011 Revised 3 June 2011 Accepted 7 June 2011

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.

Keywords: Acetabulum, Both column fracture, Surgical treatment, Fixation method

Figures and Tables

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.

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.

Table 1

Demographic Data

^*W/C Group: Wire/Cable Group, ^†P/S Group: Plate/Screw Group

Table 2

Reduction Status According to the Fixation Methods

^*W/C Group: Wire/Cable Group, ^†P/S Group: Plate/Screw Group

Table 3

Clinical Results According to the Reduction Status in Wire/Cable Group

Table 4

Clinical Results According to the Reduction Status in Plate/Screw Group

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