Single versus double column fixation in transverse fractures of the acetabulum: A randomised controlled trial |
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| Affiliation: | 1. Department of Orthopedic Surgery, Keck School of Medicine of University of Southern California, 1520 San Pablo St, Suite 2000, Los Angeles, CA, 90033, United States;2. Department of Orthopedic Surgery, Washington University in St Louis, 660 S Euclid Ave., St. Louis, MO, 63110, United States;3. Keck School of Medicine of University of Southern California, 1520 San Pablo St, Suite 2000, Los Angeles, CA, 90033, United States;4. Department of Surgery, Los Angeles County + USC Medical Center, 1983 Marengo St., Los Angeles, CA, 90033, United States;1. Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark St, Whitechapel, E1 2AT, London, UK;2. 401 General Military Hospital of Athens, P. Kanellopoulou Ave., Athens, 11525, Greece;3. 1st Propaedeutic Surgical Clinic, Athens Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, Athens, 11527, Greece;4. 4th Surgical Clinic, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini str, Haidari, Athens, 12462, Greece;1. Department of Orthopaedic Surgery, HongHui Hospital, Xi''an Jiaotong University, Xi''an, China;2. Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA;3. Department of Ultrasound, HongHui Hospital, Xi''an Jiaotong University, Xi''an, China;4. Xi''an Medical University, Xi''an, China;1. Department of Plastic Reconstructive and Faciomaxillary Surgery, Madras Medical College, Chennai-3, India;2. Institute of Orthopedics and Traumatology, Madras Medical College, Chennai-3, India |
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| Abstract: | IntroductionBiomechanical studies have compared fixation methods in transverse acetabular fractures, yet there is not enough clinical data to suggest an optimal fixation method. The aim of this randomized controlled trail was to compare fracture stability in posterior plating alone versus posterior plating and anterior column lag-screw fixation in treatment of transverse and transverse with posterior wall acetabular fractures.MethodsThirty patients were randomized to one of two groups, either posterior fixation alone (single column group), or posterior plating and anterior fixation with percutaneous anterior column screw (double column group). Patients were followed up with serial radiographic assessments documenting any loss of reduction, utilizing Matta’s radiological criteria, measuring the roof arc angles and by measuring any change in the femoral head offset.ResultsFifteen patients were randomized to each group. Mean patient age was 31 years, mean follow up period was 19 months (range 12–24). There was no significant differences between the two groups with regards the quality of post-operative reduction, blood loss, hospital stay and functional score using the modified Merle D'Aubinge and Postel score. The operative time was significantly longer in the double column fixation group (130 min versus 104 min). There was no loss of reduction observed in either of the two groups.ConclusionSingle poster column fixation in transverse and transverse posterior wall fractures showed similar result to double column fixation, in terms of fractures stability in the follow up period, quality of reduction and early functional outcome. |
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| Keywords: | Acetabular Transverse Fracture Column Fixation |
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