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Spring Plate as an Adjunct in Posterior Acetabular Wall Fractures; Surgical Technique and Results

February 19, 2016

Contributors: Naveen Tummala, MS ; Ashok Sunil Gavaskar Kumaresan, MS; Ashok Sunil Gavaskar Kumaresan, MS

BACKGROUND: The hip joint is often rendered unstable after a posterior wall fracture and surgical management is often indicated to restore hip stability and congruency. The conventional surgical technique makes use of lag screws and buttress plates for internal fixation of these fractures. The use of spring plates in addition to buttress plating has been described before and has shown to significantly improve the strength of fixation. In this video, we clearly show the use of a spring plate in combination with lag screw and buttress plate fixation for a comminuted posterior wall fracture. We also discuss mid-term results of a case series of patients operated using the technique as part of this video.

SURGICAL TECHNIQUE: The patient is positioned prone and a Kocher Langenbeck approach is used. The sciatic nerve is identified and protected. Fracture reduction is performed and stabilized provisionally. Definitive fixation starts with the use of a 3-holed convex spring plate to stabilize the fracture, followed by insertion of a lag screw and buttressing with a 3.5 mm pelvic reconstruction plate. Intraoperative Judet views are performed to assess fracture reduction and screw position.

GOALS: The goal of this video is to show the exact surgical technique of open reduction and internal fixation of a comminuted posterior wall acetabular fracture using the spring plate in a step-wise manner. After viewing this video, the surgeon is able to appreciate and fully understand the steps involved in fixation of a posterior acetabular wall fractures with this technique.

Results for "Hip and Pelvis"

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