| Objective To explore the efficacy of lateral-rectus approach combined with 3D printing technology for the treatment of acetabular fractures involving quadrilateral surface. Methods A total of 22 patients with acetabular fractures involving quadrilateral surface were admitted to the First People's Hospital of Zhaoqing from September 2014 to August 2018. There were 16 males and 6 females, with an average age of 42.6 years (from 17 to 68 years). According to the Letournel-Judet classification, there were 4 anterior column fractures, 8 anterior and posterior hemi-transverse fractures, 5 both-column fractures, 3 transverse fractures, and 2 T-shaped fractures. For all cases a preoperative surgical simulation was implemented based on their 3D-printed acetabular models. A pre-bent reconstruction plate was placed to fixate the fracture after reduction via the lateral-rectus approach,and the posterior column was fixed with hollow screw. The reduction quality,function of affected hip and complications were recorded. Results The 22 patients were followed up for an average time of 28.5 months (range, 18-41 months). According to the Matta standard evaluation, the postoperative reduction was rated as excellent in 15 cases, good in 5 cases,and fair in 2 cases. The excellent/good rate was 90.9%(20/22). According to the modified Merle d'Aubigne-Postel scoring at the final follow-up, the average score of affected hip function was 16.3(range score 13-18).Among them,13 cases were categorized as excellent,6 cases as good, and 3 cases as fair. The excellent and good rate was 86.4%(19/22). Complications included deep venous thrombosis in 1 case and fatty fluidization in 1 case, and the incidence of complication was 9.1%(2/22). Conclusion Surgical management through the lateral-rectus approach can provide clear anatomy, adequate exposure, and small trauma. Acetabular fractures involving quadrilateral surface can be reducted and fixed directly, and 3D printing technology combined treatment for this type of fracture, can reduce the operation time and intraoperative blood loss, reduce the incidence of complications, provide accurate minimally invasive surgery, and obtain satisfactory therapeutic effect. |
