The use of Verbrugge forceps for reduction of the posterior column element in displaced acetabular fractures: clinical and radiological evaluation

Purpose Different reduction techniques and tools are described to facilitate anatomical reduction of acetabular fractures. However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This stud...

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Veröffentlicht in:European journal of trauma and emergency surgery (Munich : 2007) 2022-04, Vol.48 (2), p.1277-1284
Hauptverfasser: Fahmy, Mahmoud, Abdelazeem, Hazem, Abdelazeem, Ahmed Hazem
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container_title European journal of trauma and emergency surgery (Munich : 2007)
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creator Fahmy, Mahmoud
Abdelazeem, Hazem
Abdelazeem, Ahmed Hazem
description Purpose Different reduction techniques and tools are described to facilitate anatomical reduction of acetabular fractures. However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This study aims at radiological and functional assessment of the effectiveness of a novel reduction technique for the posterior column element in displaced acetabular fractures. Methods A prospective study was conducted for evaluation of a novel reduction technique; the use of the conventional large holding Verbrugge forceps for reduction of posterior column and transverse, with or without posterior wall, fractures. Intra-operative safety and reduction time were evaluated. The immediate postoperative quality of reduction was assessed using Matta radiographic criteria. The functional outcome was evaluated at the latest follow-up visit using the modified Merle d’Aubigne and Postel (MDP) score. Results Thirty patients with a mean follow-up of 18.1 months were included. Fifteen had transverse/posterior wall, ten had transverse, and five had posterior column fractures. All fractures were displaced ≥ 2 mm on anteroposterior and/or Judet views of the pelvis without traction. The average operative time was 100.4 min with 12.5 min reduction time. No intra-operative complications were encountered. Twenty-three patients (76.6%) had anatomical while seven (23.3%) had imperfect reduction. The functional outcome score was excellent in three patients, good in 18, fair in four, and poor in five patients at the latest follow-up. Conclusion The use of the conventional large Verbrugge bone-holding forceps for the reduction of the posterior column element in displaced acetabular fractures using the Kocher–Langenbeck approach is a safe, effective, time-saving, and technically undemanding procedure.
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However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This study aims at radiological and functional assessment of the effectiveness of a novel reduction technique for the posterior column element in displaced acetabular fractures. Methods A prospective study was conducted for evaluation of a novel reduction technique; the use of the conventional large holding Verbrugge forceps for reduction of posterior column and transverse, with or without posterior wall, fractures. Intra-operative safety and reduction time were evaluated. The immediate postoperative quality of reduction was assessed using Matta radiographic criteria. The functional outcome was evaluated at the latest follow-up visit using the modified Merle d’Aubigne and Postel (MDP) score. Results Thirty patients with a mean follow-up of 18.1 months were included. Fifteen had transverse/posterior wall, ten had transverse, and five had posterior column fractures. All fractures were displaced ≥ 2 mm on anteroposterior and/or Judet views of the pelvis without traction. The average operative time was 100.4 min with 12.5 min reduction time. No intra-operative complications were encountered. Twenty-three patients (76.6%) had anatomical while seven (23.3%) had imperfect reduction. The functional outcome score was excellent in three patients, good in 18, fair in four, and poor in five patients at the latest follow-up. Conclusion The use of the conventional large Verbrugge bone-holding forceps for the reduction of the posterior column element in displaced acetabular fractures using the Kocher–Langenbeck approach is a safe, effective, time-saving, and technically undemanding procedure.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-021-01629-9</identifier><identifier>PMID: 33677629</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acetabulum - diagnostic imaging ; Acetabulum - injuries ; Acetabulum - surgery ; Critical Care Medicine ; Emergency medical care ; Emergency Medicine ; Fracture Fixation, Internal - methods ; Fractures ; Fractures, Bone - diagnostic imaging ; Fractures, Bone - surgery ; Hip Fractures - surgery ; Hip joint ; Humans ; Intensive ; Medicine ; Medicine &amp; Public Health ; Original Article ; Orthopedic apparatus ; Orthopedics ; Prospective Studies ; Spinal Fractures ; Sports Medicine ; Surgery ; Surgical Instruments ; Surgical Orthopedics ; Surgical techniques ; Traumatic Surgery ; Treatment Outcome</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2022-04, Vol.48 (2), p.1277-1284</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. 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However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This study aims at radiological and functional assessment of the effectiveness of a novel reduction technique for the posterior column element in displaced acetabular fractures. Methods A prospective study was conducted for evaluation of a novel reduction technique; the use of the conventional large holding Verbrugge forceps for reduction of posterior column and transverse, with or without posterior wall, fractures. Intra-operative safety and reduction time were evaluated. The immediate postoperative quality of reduction was assessed using Matta radiographic criteria. The functional outcome was evaluated at the latest follow-up visit using the modified Merle d’Aubigne and Postel (MDP) score. Results Thirty patients with a mean follow-up of 18.1 months were included. Fifteen had transverse/posterior wall, ten had transverse, and five had posterior column fractures. All fractures were displaced ≥ 2 mm on anteroposterior and/or Judet views of the pelvis without traction. The average operative time was 100.4 min with 12.5 min reduction time. No intra-operative complications were encountered. Twenty-three patients (76.6%) had anatomical while seven (23.3%) had imperfect reduction. The functional outcome score was excellent in three patients, good in 18, fair in four, and poor in five patients at the latest follow-up. 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However, maintenance of reduction, plate placement, and fracture fixation remain a challenge owing to the large surface area occupied by the available reduction tools. This study aims at radiological and functional assessment of the effectiveness of a novel reduction technique for the posterior column element in displaced acetabular fractures. Methods A prospective study was conducted for evaluation of a novel reduction technique; the use of the conventional large holding Verbrugge forceps for reduction of posterior column and transverse, with or without posterior wall, fractures. Intra-operative safety and reduction time were evaluated. The immediate postoperative quality of reduction was assessed using Matta radiographic criteria. The functional outcome was evaluated at the latest follow-up visit using the modified Merle d’Aubigne and Postel (MDP) score. Results Thirty patients with a mean follow-up of 18.1 months were included. Fifteen had transverse/posterior wall, ten had transverse, and five had posterior column fractures. All fractures were displaced ≥ 2 mm on anteroposterior and/or Judet views of the pelvis without traction. The average operative time was 100.4 min with 12.5 min reduction time. No intra-operative complications were encountered. Twenty-three patients (76.6%) had anatomical while seven (23.3%) had imperfect reduction. The functional outcome score was excellent in three patients, good in 18, fair in four, and poor in five patients at the latest follow-up. Conclusion The use of the conventional large Verbrugge bone-holding forceps for the reduction of the posterior column element in displaced acetabular fractures using the Kocher–Langenbeck approach is a safe, effective, time-saving, and technically undemanding procedure.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33677629</pmid><doi>10.1007/s00068-021-01629-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5700-493X</orcidid></addata></record>
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subjects Acetabulum - diagnostic imaging
Acetabulum - injuries
Acetabulum - surgery
Critical Care Medicine
Emergency medical care
Emergency Medicine
Fracture Fixation, Internal - methods
Fractures
Fractures, Bone - diagnostic imaging
Fractures, Bone - surgery
Hip Fractures - surgery
Hip joint
Humans
Intensive
Medicine
Medicine & Public Health
Original Article
Orthopedic apparatus
Orthopedics
Prospective Studies
Spinal Fractures
Sports Medicine
Surgery
Surgical Instruments
Surgical Orthopedics
Surgical techniques
Traumatic Surgery
Treatment Outcome
title The use of Verbrugge forceps for reduction of the posterior column element in displaced acetabular fractures: clinical and radiological evaluation
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