title: The submuscular sliding plate technique for acetabular posterior wall fractures extending to the acetabular roof.
abstract: There is extension of the Kocher-Langenbeck approach using trochanteric osteotomy for posterior wall fracture extending to acetabular roof, but it exposes to complications such as nonunion, breakage, and heterotopic ossification. The current study introduces a submuscular sliding plate technique. We retrospectively analyzed 13 patients treated with this technique. It is based on conventional method for posterior wall fracture. After reduction of roof fragment with direct visualization, a pre-contoured plate was passed through a submuscular tunnel under the gluteus medius and minimus. A small split incision was performed on the muscles, and screws were inserted with a triple trocar complex safely under fluoroscopic imaging. All patients had fracture union without complications. X-rays results showed anatomical reduction in 10 cases and imperfect reduction in 3 cases. Our results were satisfactory, particularly without heterotopic ossifications despite no prophylactic regimen of NSAID was applied and no neurological complications, so we believe that this technique is a good option for posterior wall fractures extending to the acetabular roof.
authors.affiliation: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: J J
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University, 875, Haeun-daero, Haeundae-gu, Busan 612-862, South Korea. Electronic address: bakpaker@hanmail.net.
authors.forename: J W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University, 875, 2240 Daehwa-dong, Ilsanseo-gu, Goyang 411-706, South Korea.
authors.forename: H K
authors.initials: HK
authors.lastname: Oh
mesh_terms: D000077:Acetabulum / Q000293:injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D001860:Bone Plates; D016208:Databases, Factual; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome
keywords: Acetabular fracture; Acetabular roof; Acetabulum; Posterior wall; Technique