M Frank1, V Dzupa2, K Smejkal3,4, V Baca5, T Dedek3. 1. Department of Surgery, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, 500 05, Czech Republic. frankmd@seznam.cz. 2. Department of Orthopaedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. 3. Department of Surgery, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, 500 05, Czech Republic. 4. Department of Field Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic. 5. Department of Anatomy, Third Faculty of Medicine of Charles University, Prague, Czech Republic.
Abstract
BACKGROUND: Dislocated acetabular fractures in polytraumatized patients are very challenging cases to deal with. Temporary stabilization by skeletal traction is difficult in these patients. A more effective solution can be an external fixation. OBJECTIVE: The authors designed a new crossover external fixation frame for acetabular fracture. The aim of this study is the biomechanical testing of this frame on human cadavers. METHODS: This study is an experiment on ten human cadavers. The acetabular fracture C2.2 was created. The stabilization effect of external fixation was compared with stabilization by large distractor. Femoral heads' shifts caused by standardized manipulation with the cadaver were obtained from X-ray pictures. RESULTS: The mean total shift in stabilization technique by external fixation was 2.56 (1-4) mm. In stabilization by large distractor, the mean of the total shift after cadaver manipulation was 5.11 (0-10) mm. No significant differences were found between stabilization by external fixation and by large distractor (p = 0.066). CONCLUSIONS: The stabilization of acetabular fracture C2.2 by a crossover external fixator is as effective as large distractor. The crossover external fixation could be a suitable solution for the temporary stabilization of acetabular fractures in polytraumatized patients. Subsequent studies including clinical trials are necessary to confirm the authors' suggestion.
BACKGROUND: Dislocated acetabular fractures in polytraumatized patients are very challenging cases to deal with. Temporary stabilization by skeletal traction is difficult in these patients. A more effective solution can be an external fixation. OBJECTIVE: The authors designed a new crossover external fixation frame for acetabular fracture. The aim of this study is the biomechanical testing of this frame on human cadavers. METHODS: This study is an experiment on ten human cadavers. The acetabular fracture C2.2 was created. The stabilization effect of external fixation was compared with stabilization by large distractor. Femoral heads' shifts caused by standardized manipulation with the cadaver were obtained from X-ray pictures. RESULTS: The mean total shift in stabilization technique by external fixation was 2.56 (1-4) mm. In stabilization by large distractor, the mean of the total shift after cadaver manipulation was 5.11 (0-10) mm. No significant differences were found between stabilization by external fixation and by large distractor (p = 0.066). CONCLUSIONS: The stabilization of acetabular fracture C2.2 by a crossover external fixator is as effective as large distractor. The crossover external fixation could be a suitable solution for the temporary stabilization of acetabular fractures in polytraumatized patients. Subsequent studies including clinical trials are necessary to confirm the authors' suggestion.
Authors: Mehdi Benkhadra; André Bouchot; Julien Gérard; Denis Genelot; Pierre Trouilloud; Laurent Martin; Claude Girard; Alain Danino; Friedrich Anderhuber; Georg Feigl Journal: Surg Radiol Anat Date: 2010-07-15 Impact factor: 1.246