The use of a structural free iliac crest autograft for the treatment of acetabular fractures
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Bone and cartilage deficits in the posterior acetabular wall are severe complications resulting from the unsuccessful management or delayed treatment of acetabular fracture. This potentially disastrous condition cannot be treated reliably with the use of reconstruction plates and screws alone. Therefore, this technical report describes a modified anatomical reconstruction method that uses a structural iliac crest autograft and an acetabular tridimensional memory alloy fixation system (ATMFS) to treat late-stage deficits in the posterior wall of the acetabulum. This paper also describes a clinical study of 22 patients with an average of 6.3 years follow-up to evaluate the clinical outcomes of this method.
Twenty-two patients, who had an acetabular reconstruction between January 2000 and December 2011 that used a structured free iliac crest autograft to treat late-stage bone and cartilage deficits in the posterior acetabular wall were followed annually with clinical and radiographic evaluations. The average age of the patients was 36.4 years at the time of the procedure, and the average time of follow-up was 6.3 years.
None of the patients in this study lost reduction after surgery, and there were no cases of implant failure. Radiographic analysis using Matta’s X-ray evaluation criteria were excellent in eleven cases, good in eight, and fair on three. The Merle D’Aubigné and Postel clinical outcomes at the final follow-up were as follows: seven cases were excellent, ten cases were good, three cases were fair and two cases were poor.
The use of a modified iliac crest grafting and ATMFS fixation, as a biological method to reconstruct the acetabulum anatomically may offer better congruence of the joint surface and may ensure good hip joint stability during early postoperative exercise. The medium to long-term results of this method are encouraging.
- Letournel E, Judet R (1993) Fractures of the acetabulum, 2nd edn. Springer, New York CrossRef
- Moed BR, Carr SE, Gruson KI et al (2003) Computed tomographic assessment of fracture of posterior wall of the acetabulum after operative treatment. J Bone Jt Surg Am 85-A:512–522
- Moed BR, Carr SE, Watson JT (2002) Results of operative treatment of fracture of the posterior wall of the acetabulum. J Bone Jt Surg Am 84-A:752–758
- Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within 3 weeks after the injury. J Bone Jt Surg Am 78(11):1632–1645
- Moed BR, Carr SE, Watson JT (2000) Open reduction and internal fixation of posterior wall fractures of the acetabulum. Clin Orthop 377:57–67 CrossRef
- Ragnasson B, Jacobsson B (1992) Epidemiology of pelvic fractures in a Swedish county. Acta Orthop Scand 63:297–300 CrossRef
- Liu XW, Xu SG, Zhang CC et al (2010) Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China. Int Orthop 34(7):1033–1040 CrossRef
- Zhang CC, Xu SG, Wang JL et al (2002) Design and clinical applications of acetabular tridimensional memory alloy-fixation system. Chin J Orthop 22(2):709–713
- Baumgartner MR (1999) Fractures of the posterior wall of the acetabulum. J Am Acad Orthop Surg 7:54–65
- Schreurs BW, Zengerink M, Welten ML et al (2005) Bone impaction grafting and a cemented cup after acetabular fracture at 3–18 years. Clin Orthop 437:145–151
- Zha GC, Sun JY, Chen L et al (2012) Late reconstruction of posterior acetabular wall fractures using iliac crest. J Trauma 72:1386–1392
- Olson SA, Bay RK, Chapman MW et al (1995) Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum. J Bone Jt Surg Am 77(8):1184–1192
- Liu XW, Xu SG, Zhang CC et al (2010) Biomechanical study of posterior wall acetabular fracture fixation using acetabular tridimensional memory alloy-fixation system. Clin Biomech 25:312–317 CrossRef
- The use of a structural free iliac crest autograft for the treatment of acetabular fractures
Archives of Orthopaedic and Trauma Surgery
Volume 133, Issue 6 , pp 773-780
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Structural free iliac crest
- Acetabular fracture
- Acetabular three-dimensional memory fixation system
- Industry Sectors