Shannon SF, et al. J Orthopedic trauma. 2020;doi:10.1097/BOT.0000000000001798.
Shannon SF, et al. J Orthopedic trauma. 2020;doi:10.1097/BOT.0000000000001798.
According to an orthopedic trauma expert, the use of microfracture plates may be effective for temporary fixation of basic and related acetabular fractures.
Steven F. Shannon, MD, from the R Adams Cowley Shock Trauma Center and his colleagues analyzed the clinical and technical microfracture plates in 57 patients with (n = 49) and basic (n = 8) acetabular fractures The effect of fixation. Series from 2013 to 2018.
According to the study, 16 patients need two plates, two patients need four plates, and one patient needs six plates. Of the 68 boards used in the entire study, 2.7-mm boards are the most commonly used, followed by 2.4-mm boards and 2-mm boards.
Overall, Shannon and colleagues found that 77% of patients (n = 44) had excellent reduction quality using micro-fragment plates. In addition, 19.3% of the patients had a fair reduction quality, and 3.5% of the patients had a poor reduction quality.
"We hope that our technology using temporary microfracture plates will become another tool for acetabular surgeons to treat challenging fractures," Shannon told Healio Orthopedics. "This technique can also be applied to other difficult fractures that a trauma surgeon may encounter in the lower and upper limbs," he said.
"The future significance of this work will be to provide more empirical data on our application of these techniques to lower and upper limb fractures (including Pilon, platform, distal femur, distal humerus, and transolecranon fractures and dislocations)," Shannon Concluded.
Cyril Mauffrey, MD, FACS, FRCS
Shannon and colleagues recently published a study in the Journal of Orthopaedic Trauma that successfully highlighted the use of temporary microfracture blocks and screws in simple and related fractures of the acetabulum. Although this technique is not new, it deserves special attention because it alleviates some of the challenges encountered during open reduction and internal fixation of acetabular fractures: 1) clamps in plate fixation; 2) use of unsuitable contour rigidity The structure, which causes the slight displacement of the acetabular fracture during the screw tightening process; 3) the flexibility of one column, allows another column to be fixed without affecting the reduction ability; and 4) better compression and absolute stability To promote primary bone healing.
The author’s work should be commended. It is worth adding some technical pearls related to this technology.
For fractures that are more likely to develop into post-traumatic arthritis and require joint replacement, I avoid placing the hardware close to the joint to avoid the need to remove the hardware.
The technique of applying micro-fragment plates around the posterior edge of the pelvis can be a delicate technical challenge. I like to drill a screw hole without an in-situ plate, measure the required screw length and place the screw outside the body through the plate, and then introduce the plate screw structure as a unit.
Alfonso NA et al. J Orthopedic trauma. 2020; doi:10.1097/BOT.0000000000001637.
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