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Published in: International Orthopaedics 7/2010

01-10-2010 | Original Paper

Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China

Authors: Xinwei Liu, Shuogui Xu, Chuncai Zhang, Jiacan Su, Baoqing Yu

Published in: International Orthopaedics | Issue 7/2010

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Abstract

Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40–50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D’Aubigne−Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply.
Literature
1.
go back to reference Letournel E, Judet R (1993) Classification. In: Elson RA (ed) Fractures of the acetabulum. Springer-Verlag, New York, pp 63–66 Letournel E, Judet R (1993) Classification. In: Elson RA (ed) Fractures of the acetabulum. Springer-Verlag, New York, pp 63–66
2.
go back to reference Giannoudis PV, Grotz MR, Papakostidis C, Dinopoulos H (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87:2–9PubMed Giannoudis PV, Grotz MR, Papakostidis C, Dinopoulos H (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87:2–9PubMed
3.
go back to reference Matta JM (1996) Fractures of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78:1632–1645PubMed Matta JM (1996) Fractures of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78:1632–1645PubMed
4.
go back to reference McLaren AC (1990) Prophylaxis with indomethacin for heterotopic bone. After open reduction of fractures of the acetabulum. J Bone Joint Surg Am 72:245–247PubMed McLaren AC (1990) Prophylaxis with indomethacin for heterotopic bone. After open reduction of fractures of the acetabulum. J Bone Joint Surg Am 72:245–247PubMed
5.
go back to reference Levi DS, Kusnezov N, Carman GP (2008) Smart materials applications for pediatric cardiovascular devices. Pediatr Res 63:552–558CrossRefPubMed Levi DS, Kusnezov N, Carman GP (2008) Smart materials applications for pediatric cardiovascular devices. Pediatr Res 63:552–558CrossRefPubMed
6.
go back to reference Oh KT, Joo UH, Park GH, Hwang CJ, Kim KN (2006) Effect of silver addition on the properties of nickel-titanium alloys for dental application. J Biomed Mater Res B Appl Biomater 76:306–314PubMed Oh KT, Joo UH, Park GH, Hwang CJ, Kim KN (2006) Effect of silver addition on the properties of nickel-titanium alloys for dental application. J Biomed Mater Res B Appl Biomater 76:306–314PubMed
7.
go back to reference Zhang CC (1993) Design of the scorpion-like dynamic nitinol osteo-connector and its use in the treatment of fractures and the nonunion of the upper extremity tubular bones. Zhonghua Wai Ke Za Zhi 31:269–271PubMed Zhang CC (1993) Design of the scorpion-like dynamic nitinol osteo-connector and its use in the treatment of fractures and the nonunion of the upper extremity tubular bones. Zhonghua Wai Ke Za Zhi 31:269–271PubMed
8.
go back to reference Zhang CC, Xu SG, Yu BQ (2004) Application of acetabular tridimensional memory fixation system (ATMFS) to treat complex acetabular fractures and its clinical significance. Chinese Journal of Orthopaedic Trauma 6:364–368 Zhang CC, Xu SG, Yu BQ (2004) Application of acetabular tridimensional memory fixation system (ATMFS) to treat complex acetabular fractures and its clinical significance. Chinese Journal of Orthopaedic Trauma 6:364–368
9.
go back to reference d’Aubigne RM, Postel M (2009) The classic: Functional results of hip arthroplasty with acrylic prosthesis. 1954. Clin Orthop Relat Res 467:7–27CrossRefPubMed d’Aubigne RM, Postel M (2009) The classic: Functional results of hip arthroplasty with acrylic prosthesis. 1954. Clin Orthop Relat Res 467:7–27CrossRefPubMed
10.
go back to reference Letournel E (1990) Diagnosis and treatment of nonunions and malunions of acetabular fractures. Orthop Clin North Am 21:769–788PubMed Letournel E (1990) Diagnosis and treatment of nonunions and malunions of acetabular fractures. Orthop Clin North Am 21:769–788PubMed
11.
go back to reference Saterbak AM, Marsh JL, Nepola JV, Brandser EA, Turbett T (2000) Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns. J Orthop Trauma 14:230–237CrossRefPubMed Saterbak AM, Marsh JL, Nepola JV, Brandser EA, Turbett T (2000) Clinical failure after posterior wall acetabular fractures: The influence of initial fracture patterns. J Orthop Trauma 14:230–237CrossRefPubMed
12.
go back to reference Müller ME (1996) The comprehensive classification of fractures of long bones, spine and pelvis, 2nd edn. Springer, Berlin Müller ME (1996) The comprehensive classification of fractures of long bones, spine and pelvis, 2nd edn. Springer, Berlin
13.
go back to reference Pantazopoulos T, Nicolopoulos CS, Babis GC, Theodoropoulos T (1993) Surgical treatment of acetabular posterior wall fractures. Injury 24:319–323CrossRefPubMed Pantazopoulos T, Nicolopoulos CS, Babis GC, Theodoropoulos T (1993) Surgical treatment of acetabular posterior wall fractures. Injury 24:319–323CrossRefPubMed
14.
go back to reference Stockle U, Hoffmann R, Nittinger M, Sudkamp NP, Haas NP (2000) Screw fixation of acetabular fractures. Int Orthop 24:143–147CrossRefPubMed Stockle U, Hoffmann R, Nittinger M, Sudkamp NP, Haas NP (2000) Screw fixation of acetabular fractures. Int Orthop 24:143–147CrossRefPubMed
15.
go back to reference Goulet JA, Rouleau JP, Mason DJ, Goldstein SA (1994) Comminuted fractures of the posterior wall of the acetabulum. A biomechanical evaluation of fixation methods. J Bone Joint Surg Am 76:1457–1463PubMed Goulet JA, Rouleau JP, Mason DJ, Goldstein SA (1994) Comminuted fractures of the posterior wall of the acetabulum. A biomechanical evaluation of fixation methods. J Bone Joint Surg Am 76:1457–1463PubMed
16.
go back to reference Im GI, Shin YW, Song YJ (2005) Fractures to the posterior wall of the acetabulum managed with screws alone. J Trauma 58:300–303CrossRefPubMed Im GI, Shin YW, Song YJ (2005) Fractures to the posterior wall of the acetabulum managed with screws alone. J Trauma 58:300–303CrossRefPubMed
17.
go back to reference Kapanen A, Ryhanen J, Danilov A, Tuukkanen J (2001) Effect of nickel-titanium shape memory metal alloy on bone formation. Biomaterials 22:2475–2480CrossRefPubMed Kapanen A, Ryhanen J, Danilov A, Tuukkanen J (2001) Effect of nickel-titanium shape memory metal alloy on bone formation. Biomaterials 22:2475–2480CrossRefPubMed
18.
go back to reference Ryhanen J, Kallioinen M, Serlo W, Peramaki P, Junila J, Sandvik P, Niemela E, Tuukkanen J (1999) Bone healing and mineralization, implant corrosion, and trace metals after nickel-titanium shape memory metal intramedullary fixation. J Biomed Mater Res 47:472–480CrossRefPubMed Ryhanen J, Kallioinen M, Serlo W, Peramaki P, Junila J, Sandvik P, Niemela E, Tuukkanen J (1999) Bone healing and mineralization, implant corrosion, and trace metals after nickel-titanium shape memory metal intramedullary fixation. J Biomed Mater Res 47:472–480CrossRefPubMed
19.
go back to reference Wever DJ, Veldhuizen AG, Sanders MM, Schakenraad JM, van Horn JR (1997) Cytotoxic, allergic and genotoxic activity of a nickel-titanium alloy. Biomaterials 18:1115–1120CrossRefPubMed Wever DJ, Veldhuizen AG, Sanders MM, Schakenraad JM, van Horn JR (1997) Cytotoxic, allergic and genotoxic activity of a nickel-titanium alloy. Biomaterials 18:1115–1120CrossRefPubMed
20.
go back to reference Assad M, Lemieux N, Rivard CH, Yahia LH (1999) Comparative in vitro biocompatibility of nickel-titanium, pure nickel, pure titanium, and stainless steel: Genotoxicity and atomic absorption evaluation. Biomed Mater Eng 9:1–12PubMed Assad M, Lemieux N, Rivard CH, Yahia LH (1999) Comparative in vitro biocompatibility of nickel-titanium, pure nickel, pure titanium, and stainless steel: Genotoxicity and atomic absorption evaluation. Biomed Mater Eng 9:1–12PubMed
21.
go back to reference Kumar A, Shah NA, Kershaw SA, Clayson AD (2005) Operative management of acetabular fractures. A review of 73 fractures. Injury 36:605–612CrossRefPubMed Kumar A, Shah NA, Kershaw SA, Clayson AD (2005) Operative management of acetabular fractures. A review of 73 fractures. Injury 36:605–612CrossRefPubMed
22.
go back to reference Ebraheim NA, Patil V, Liu J, Sanford CG Jr, Haman SP (2007) Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures. Int Orthop 31:671–675CrossRefPubMed Ebraheim NA, Patil V, Liu J, Sanford CG Jr, Haman SP (2007) Reconstruction of comminuted posterior wall fractures using the buttress technique: a review of 32 fractures. Int Orthop 31:671–675CrossRefPubMed
Metadata
Title
Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China
Authors
Xinwei Liu
Shuogui Xu
Chuncai Zhang
Jiacan Su
Baoqing Yu
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 7/2010
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-009-0867-1

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