title: Development of site-specific locking plates for acetabular fractures.
abstract: Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.
authors.affiliation: Department of Orthopaedics, The General Hospital of Chinese People’s Liberation Army, No 28 Fuxing Rd, Beijing, 100853, PR. China.
authors.forename: Meng
authors.initials: M
authors.lastname: Xu
authors.forename: Li-Hai
authors.initials: LH
authors.lastname: Zhang
authors.forename: Ying-Ze
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Chun-Qing
authors.initials: CQ
authors.lastname: He
authors.forename: Li-Cheng
authors.initials: LC
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Pei-Fu
authors.initials: PF
authors.lastname: Tang
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D019544:Equipment Failure Analysis; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult