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Research article
xianhua cai
PLA Middle Military Command General Hospital
Corresponding Author
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Background Surgical treatment of acetabular fractures involving quadrilateral plate is a challenge to orthopaedic surgeons. We have developed a novel fixation technique using a special shaped reconstruction plate combined with several buttress screws of quadrilateral plate which was also called Dynamic Anterior Plate-Screw System for Quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005(RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, anatomical titanium plate (ATP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the ATP group during the inclusion period (2016-2018), and were matched to 22 cases in our database of RP group (2008-2016). The primary outcome measures were quality of reduction and functional outcomes. Intraoperative conditions were also compared. Results Of these 22 consecutive patients in ATP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12-37). There were no significant differences between the two groups with regards the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score( P > 0.05). Compared with the RP group, the ATP group has a shorter operation time(245.1 minutes vs. 286.8 minutes, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3mL, P = 0.014) and transfusion (780.9 vs. 1256.8mL, P = 0.035). The complication rate was 18.2% in ATP group, and there was no significantly difference compared with the RP group (36.4%)( P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusion s The fixation of anatomical titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The anatomical titanium plate of DAPSQ has the advantages of short operation time, less intraoperative bleeding and blood transfusion, and it is worth further promotion and research.
Keywords
Acetabular fracture; Quadrilateral; Fracture reduction; Fixation; Reconstruction plate; Models, Anatomic
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CURRENT STATUS: Published
View the published article at Journal of Orthopaedic Surgery and Research.
Version 2
Posted 03 Mar, 2020
No community comments so far
Editorial decision: Accept
On 01 Apr, 2020
Reviewers invited
Invitations sent on 08 Mar, 2020
Reviewer #1 agreed
On 08 Mar, 2020
Review #1 received
Received 08 Mar, 2020
Editor assigned
On 03 Mar, 2020
Submission checks complete
On 02 Mar, 2020
Editor invited
On 02 Mar, 2020
No comments provided
Editorial decision: Major revision
On 29 Jan, 2020
Review #2 received
Received 26 Jan, 2020
Review #4 received
Received 26 Jan, 2020
Reviewer #7 agreed
On 24 Jan, 2020
Reviewer #5 agreed
On 22 Jan, 2020
Reviewer #6 agreed
On 22 Jan, 2020
Reviewer #4 agreed
On 22 Jan, 2020
Reviewer #3 agreed
On 20 Jan, 2020
Review #3 received
Received 20 Jan, 2020
Review #1 received
Received 20 Jan, 2020
Reviewers invited
Invitations sent on 19 Jan, 2020
Reviewer #1 agreed
On 19 Jan, 2020
Reviewer #2 agreed
On 19 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor assigned
On 16 Jan, 2020
Editor invited
On 15 Jan, 2020
First submitted
On 14 Jan, 2020
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See the published version of this preprint at Journal of Orthopaedic Surgery and Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
xianhua cai
PLA Middle Military Command General Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Orthopaedic Surgery and Research.
Version 2
Posted 03 Mar, 2020
No community comments so far
Editorial decision: Accept
On 01 Apr, 2020
Reviewers invited
Invitations sent on 08 Mar, 2020
Reviewer #1 agreed
On 08 Mar, 2020
Review #1 received
Received 08 Mar, 2020
Editor assigned
On 03 Mar, 2020
Submission checks complete
On 02 Mar, 2020
Editor invited
On 02 Mar, 2020
No comments provided
Editorial decision: Major revision
On 29 Jan, 2020
Review #2 received
Received 26 Jan, 2020
Review #4 received
Received 26 Jan, 2020
Reviewer #7 agreed
On 24 Jan, 2020
Reviewer #5 agreed
On 22 Jan, 2020
Reviewer #6 agreed
On 22 Jan, 2020
Reviewer #4 agreed
On 22 Jan, 2020
Reviewer #3 agreed
On 20 Jan, 2020
Review #3 received
Received 20 Jan, 2020
Review #1 received
Received 20 Jan, 2020
Reviewers invited
Invitations sent on 19 Jan, 2020
Reviewer #1 agreed
On 19 Jan, 2020
Reviewer #2 agreed
On 19 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor assigned
On 16 Jan, 2020
Editor invited
On 15 Jan, 2020
First submitted
On 14 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Orthopaedic Surgery and Research.
Background Surgical treatment of acetabular fractures involving quadrilateral plate is a challenge to orthopaedic surgeons. We have developed a novel fixation technique using a special shaped reconstruction plate combined with several buttress screws of quadrilateral plate which was also called Dynamic Anterior Plate-Screw System for Quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005(RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, anatomical titanium plate (ATP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the ATP group during the inclusion period (2016-2018), and were matched to 22 cases in our database of RP group (2008-2016). The primary outcome measures were quality of reduction and functional outcomes. Intraoperative conditions were also compared. Results Of these 22 consecutive patients in ATP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12-37). There were no significant differences between the two groups with regards the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score( P > 0.05). Compared with the RP group, the ATP group has a shorter operation time(245.1 minutes vs. 286.8 minutes, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3mL, P = 0.014) and transfusion (780.9 vs. 1256.8mL, P = 0.035). The complication rate was 18.2% in ATP group, and there was no significantly difference compared with the RP group (36.4%)( P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusion s The fixation of anatomical titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The anatomical titanium plate of DAPSQ has the advantages of short operation time, less intraoperative bleeding and blood transfusion, and it is worth further promotion and research.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
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