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Results of Transverse Acetabular Fracture Fixation with Both Column Screws Only Versus Plate and Column Screw
Sunit Hazra1, Sourav Ghosh1, Mainak Chandra1
1Department of Orthopedics, R. G. Kar Medical College, 1 Khudiram Bose Sarani, Kolkata, 700004 India.
Introduction:
There has always been a debate regarding the fixation strategy of transverse acetabular fractures. We hypothesized that fixation strength of both column screws would be sufficient to withstand the physiological load across hip joint, resulting in similar functional and radiological outcomes with lower morbidity than plate and column screw combinations in transverse acetabular fractures.
Material And Methods:
A total of 44 transverse acetabular fracture patients without significant comminution were divided them into three groups based on the type of treatment received, viz., group A which underwent fixation with anterior and posterior column screw (19 patients), group B which underwent fixation with anterior column screw and posterior column plate (15 patients), and group C which underwent fixation with anterior column plate and posterior column screw (10 patients). Radiological adequacy of fixation was determined by comparing the fracture gap or step as per Matta radiological accuracy at immediate post-op and 8 weeks, as well as comparison of horizontal and vertical displacement of the centre of rotation of the femur head at immediate post-op and at 12 weeks. Operative morbidity was also assessed in terms of blood loss and surgical time. Intraoperative radiation exposure was also determined.
Results:
All three groups showed satisfactory outcomes in terms of fixation. There was no statistically significant difference between the three groups in terms of loss of reduction assessed by an increase in gap or step or increase in horizontal and vertical distance of the centre of rotation of the femur head at predefined time intervals after surgery. Radiation exposure was also comparable in the three groups. However, group A showed a significantly lesser blood loss and operative time in comparison to groups B and C.
Conclusion:
In comparison to other methods of fixation for transverse acetabular fractures, both column screw fixation offers an adequate fixation strength along with the added benefit of decreased operative morbidity.
