title: [Application of acetabular tridimensional memory alloy-fixation system in treatment of old acetabular posterior wall fracture with bone defect].
abstract: OBJECTIVE
  To investigate the effectiveness of acetabular tridimensional memory alloy-fixation system (ATMFS) combined with autologous iliac bone in the treatment of old acetabular posterior wall fracture with bone defect.
  
  
  METHODS
  Between January 2002 and February 2009, 17 patients with old acetabular posterior wall fracture and bone defect were treated, including 11 males and 6 females with an average age of 41.7 years (range, 20-60 years). The time from fracture to admission was 14-180 days (mean, 63 days). The displacement of the acetabular articular surface was more than or equal to 3 mm. According to the America Association of Orthopedic Surgeon (AAOS) acetabular fracture and defect classification standard, there were 4 cases of type I, 6 cases of type II, 5 cases of type III, and 2 cases of type IV. After the residual fracture fragments of the acetabular posterior wall and soft tissue hyperplasia were removed, the femoral head was reduced, and posterior wall defect was repaired with autologous iliac bone graft; ATMFS was used to fix acetabular posterior wall and artificial capsular ligament to reconstruct the hip so as to prevent re-dislocation of the femoral head.
  
  
  RESULTS
  According to Matta imaging assessment standard, the results were excellent in 8 cases, good in 6 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 82.3%. All incisions healed by first intention, and no sciatic nerve injury occurred. All patients were followed up 1-8 years (mean, 3.9 years). The mean time of fracture union was 3.6 months (range, 2-6 months). Avascular necrosis of femoral head occurred in 1 case, heterotopic ossification around the acetabulum in 1 case. According to Merle d'Aubigné-Postel scoring system evaluation, the clinical results were excellent in 9 cases, good in 6 cases, fair in 1 case, and poor in 1 case with an excellent and good rate of 88.2%.
  
  
  CONCLUSIONS
  ATMFS combined with autologous iliac bone graft and artificial ligament reconstruction of the hip joint capsule is a good choice for the treatment of old acetabular posterior wall fractures with bone defect, which can resume the posterior hip joint stability and prevent re-dislocation of the femoral head.
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, PR China.
authors.forename: Liehu
authors.initials: L
authors.lastname: Cao
authors.forename: Guangquan
authors.initials: G
authors.lastname: Bao
authors.forename: Chuncai
authors.initials: C
authors.lastname: Zhang
authors.forename: Xinwei
authors.initials: X
authors.lastname: Liu
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Niu
authors.forename: Shuogui
authors.initials: S
authors.lastname: Xu
authors.forename: Jiacan
authors.initials: J
authors.lastname: Su
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000328:Adult; D000497:Alloys; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D025981:Hip Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000497:Alloys