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Comparative study of anatomical locking plate and reconstruction plate in treating acetabular fractures

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Abstract

Purpose

This study aims to compare the effectiveness of anatomic locking plate and reconstruction plate used in treating acetabular fractures.

Methods

From January 2009 to January 2016, patients with acetabular fractures were included in this retrospective study. We grouped the patients into two groups based on the internal fixation: reconstruction plate group (RPG) and anatomic locking plate group (ALPG). The operation time, blood loss, intra-operative screw penetration, and plate breakage were compared between the two groups. The intra-operative fluoroscopic images were used to evaluate the fixation location. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on the Merle d’Aubigne-Postel score.

Results

Eighty-three patients were included in this study and were followed up for an average of 35 months (range, 25 to 42 months). Thirty-five patients were treated with the anatomical locking plate, and 48 patients were treated with the reconstruction plate. The mean surgical time was significantly shorter (P < 0.0001) in ALPG patients than in RPG patients, and the intra-operative blood loss was significantly lower (P = 0.008). The rates of intra-operative screw penetration or plate breakage in the ALPG (0/35) are significantly lower than that in the RPG (7/48) (P = 0.018). Post-operative Matta score (P = 0.905), Merle d’Aubigne-Postel score (P = 0.957), and overall complication rates (P = 0.391) were not significantly different among the groups.

Conclusion

Patients treated by anatomical locking plate had shorter operation time, less bleeding, and lower rate screw perforation compared to patients treated by reconstruction plate. Anatomical locking plate is a better choice for acetabulum fractures, especially complicated fractures.

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Availability of data and materials

Data and materials relating to the study were accessed from the case systems at our department.

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Author notes

  1. Zhijiang Li and Jiantao Li contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China

    Zhijiang Li, Jiantao Li, Zhirui Li, Shaobo Nie, Hao Zhang, Ming Li, Jianheng Liu, Zhongyang Liu, Gaoxiang Xu, Licheng Zhang & Peifu Tang

  2. National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, No. 28 Fuxing Road, Beijing, 100853, China

    Zhijiang Li, Jiantao Li, Zhirui Li, Shaobo Nie, Hao Zhang, Ming Li, Jianheng Liu, Zhongyang Liu, Gaoxiang Xu, Licheng Zhang & Peifu Tang

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  1. Zhijiang Li
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Contributions

Peifu Tang and Licheng Zhang: contribution to the research design, data acquisition, and revising it critically; Zhijiang Li and Jiantao Li: data acquisition, drafting the paper, and approval of the submitted and final version; Zhirui Li, Shaobo Nie, and Hao Zhang: data acquisition, statistical analysis, and approval of the submitted and final version; Ming Li, Jianheng Liu, Zhongyang Liu, and Gaoxiang Xu: data acquisition and approval of the submitted and final version.

Corresponding authors

Correspondence to Licheng Zhang or Peifu Tang.

Ethics declarations

Ethics approval

The study has been approved by the Ethics Committee of Chinese PLA General Hospital under Grant No. S2020-115-01 and written informed consent was obtained from the patients for the publication of individual clinical details and accompanying images. This research has been conducted according to the ethical principles expressed in the Declaration of Helsinki.

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Written informed consent was obtained from the patients for the publication of individual clinical details and accompanying images.

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Written informed consent was obtained from the patients for the publication of individual clinical details and accompanying images.

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The authors declare that they have no conflicts of interest.

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Li, Z., Li, J., Li, Z. et al. Comparative study of anatomical locking plate and reconstruction plate in treating acetabular fractures. International Orthopaedics (SICOT) 45, 2727–2734 (2021). https://doi.org/10.1007/s00264-021-04970-1

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