International Orthopaedics

, Volume 34, Issue 7, pp 1033–1040 | Cite as

Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China

  • Xinwei Liu
  • Shuogui Xu
  • Chuncai Zhang
  • Jiacan Su
  • Baoqing Yu
Original Paper
First Online:
Received:
Revised:
Accepted:

Abstract

Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40–50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D’Aubigne−Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply.

Keywords

Heterotopic Ossification Acetabular Fracture Anatomical Reduction Posterior Wall Fracture Traumatic Arthritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Notes

Competing Interests

The authors declare that they have no conflicting interests.

References

  1. 1.
    Letournel E, Judet R (1993) Classification. In: Elson RA (ed) Fractures of the acetabulum. Springer-Verlag, New York, pp 63–66Google Scholar
  2. 2.
    Giannoudis PV, Grotz MR, Papakostidis C, Dinopoulos H (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87:2–9PubMedGoogle Scholar
  3. 3.
    Matta JM (1996) Fractures of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78:1632–1645PubMedGoogle Scholar
  4. 4.
    McLaren AC (1990) Prophylaxis with indomethacin for heterotopic bone. After open reduction of fractures of the acetabulum. J Bone Joint Surg Am 72:245–247PubMedGoogle Scholar
  5. 5.
    Levi DS, Kusnezov N, Carman GP (2008) Smart materials applications for pediatric cardiovascular devices. Pediatr Res 63:552–558CrossRefPubMedGoogle Scholar
  6. 6.
    Oh KT, Joo UH, Park GH, Hwang CJ, Kim KN (2006) Effect of silver addition on the properties of nickel-titanium alloys for dental application. J Biomed Mater Res B Appl Biomater 76:306–314PubMedGoogle Scholar
  7. 7.
    Zhang CC (1993) Design of the scorpion-like dynamic nitinol osteo-connector and its use in the treatment of fractures and the nonunion of the upper extremity tubular bones. Zhonghua Wai Ke Za Zhi 31:269–271PubMedGoogle Scholar
  8. 8.
    Zhang CC, Xu SG, Yu BQ (2004) Application of acetabular tridimensional memory fixation system (ATMFS) to treat complex acetabular fractures and its clinical significance. Chinese Journal of Orthopaedic Trauma 6:364–368Google Scholar
  9. 9.
    d’Aubigne RM, Postel M (2009) The classic: Functional results of hip arthroplasty with acrylic prosthesis. 1954. Clin Orthop Relat Res 467:7–27CrossRefPubMedGoogle Scholar
  10. 10.
    Letournel E (1990) Diagnosis and treatment of nonunions and malunions of acetabular fractures. Orthop Clin North Am 21:769–788PubMedGoogle Scholar
  11. 11.
    Saterbak AM, Marsh JL, Nepola JV, Brandser EA, Turbett T (2000) Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns. J Orthop Trauma 14:230–237CrossRefPubMedGoogle Scholar
  12. 12.
    Müller ME (1996) The comprehensive classification of fractures of long bones, spine and pelvis, 2nd edn. Springer, BerlinGoogle Scholar
  13. 13.
    Pantazopoulos T, Nicolopoulos CS, Babis GC, Theodoropoulos T (1993) Surgical treatment of acetabular posterior wall fractures. Injury 24:319–323CrossRefPubMedGoogle Scholar
  14. 14.
    Stockle U, Hoffmann R, Nittinger M, Sudkamp NP, Haas NP (2000) Screw fixation of acetabular fractures. Int Orthop 24:143–147CrossRefPubMedGoogle Scholar
  15. 15.
    Goulet JA, Rouleau JP, Mason DJ, Goldstein SA (1994) Comminuted fractures of the posterior wall of the acetabulum. A biomechanical evaluation of fixation methods. J Bone Joint Surg Am 76:1457–1463PubMedGoogle Scholar
  16. 16.
    Im GI, Shin YW, Song YJ (2005) Fractures to the posterior wall of the acetabulum managed with screws alone. J Trauma 58:300–303CrossRefPubMedGoogle Scholar
  17. 17.
    Kapanen A, Ryhanen J, Danilov A, Tuukkanen J (2001) Effect of nickel-titanium shape memory metal alloy on bone formation. Biomaterials 22:2475–2480CrossRefPubMedGoogle Scholar
  18. 18.
    Ryhanen J, Kallioinen M, Serlo W, Peramaki P, Junila J, Sandvik P, Niemela E, Tuukkanen J (1999) Bone healing and mineralization, implant corrosion, and trace metals after nickel-titanium shape memory metal intramedullary fixation. J Biomed Mater Res 47:472–480CrossRefPubMedGoogle Scholar
  19. 19.
    Wever DJ, Veldhuizen AG, Sanders MM, Schakenraad JM, van Horn JR (1997) Cytotoxic, allergic and genotoxic activity of a nickel-titanium alloy. Biomaterials 18:1115–1120CrossRefPubMedGoogle Scholar
  20. 20.
    Assad M, Lemieux N, Rivard CH, Yahia LH (1999) Comparative in vitro biocompatibility of nickel-titanium, pure nickel, pure titanium, and stainless steel: Genotoxicity and atomic absorption evaluation. Biomed Mater Eng 9:1–12PubMedGoogle Scholar
  21. 21.
    Kumar A, Shah NA, Kershaw SA, Clayson AD (2005) Operative management of acetabular fractures. A review of 73 fractures. Injury 36:605–612CrossRefPubMedGoogle Scholar
  22. 22.
    Ebraheim NA, Patil V, Liu J, Sanford CG Jr, Haman SP (2007) Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures. Int Orthop 31:671–675CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Xinwei Liu
    • 1
  • Shuogui Xu
    • 1
  • Chuncai Zhang
    • 1
  • Jiacan Su
    • 1
  • Baoqing Yu
    • 1
  1. 1.Department of Orthopaedic Surgery, Changhai HospitalThe Second Military Medical UniversityShanghaiChina

Personalised recommendations