Technical note: novel utilization of an H-plate for the treatment of posterior wall components of acetabular fractures
Abstract
Posterior wall components of acetabular fractures are challenging injuries to treat due to the frequency of comminution, marginal impaction and high contact forces of the femoral head on the posterior wall. A variety of fixation techniques for these components have been utilized including conventional buttress plating and free screws. The objective of this report is to describe the technical application of the DePuy Synthes 2.7mm nonlocking hindfoot and midfoot plate, a 5-hole implant (the "H-plate") (DePuy Synthes; Raynham, MA), in the surgical treatment of posterior wall fractures and to present early clinical outcomes from its use. We report a series of 95 patients who underwent fixation of posterior wall components of acetabular fractures (AO/OTA 62) with an H-plate construct. At a mean follow-up of 257 days, conversion to total hip arthroplasty occurred in six patients (6.3%), there were no postoperative dislocations, four surgical site infections (4.2%), and no cases required revision open reduction internal fixation. The H-plate's overall shape may enhance stability due to its width and design, and these early results suggest that the H-plate may represent a viable option for stabilization of posterior wall fractures. LEVEL OF EVIDENCE: III.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 95 participants or records.
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