Abstract
Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.
- 1.Ferguson TA, Patel R, Bhandari M, Matta JM. Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 2010; 92(2):250–257. Crossref Medline, Google Scholar
- 2.Pagenkopf E, Grose A, Partal G, Helfet DL. Acetabular fractures in the elderly: treatment recommendations. HSS J. 2006; 2(2):161–171
10.1007/s11420-006-9010-7 . Crossref Medline, Google Scholar - 3.Cornell CN. Hip fractures in the elderly: on the acetabular side. Orthopedics. 2004; 27(9):931–932. Link, Google Scholar
- 4.Toro JB, Hierholzer C, Helfet DL. Acetabular fractures in the elderly. Bull Hosp Jt Dis. 2004; 62(1–2):53–57. Medline, Google Scholar
- 5.Cornell CN. Management of acetabular fractures in the elderly patient. HSS J. 2005; 1(1):25–30
10.1007/s11420-005-0101-7 . Crossref Medline, Google Scholar - 6.Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 2005; (430):176–181
10.1097/01.blo.0000137554.91189.a9 . Crossref Medline, Google Scholar - 7.Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstatter J, Gabl M. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg. 2005; 125(6):399–404
10.1007/s00402-005-0820-8 . Crossref Medline, Google Scholar - 8.Schliemann B, Siemoneit J, Theisen C, Kosters C, Weimann A, Raschke MJ. Complex fractures of the proximal humerus in the elderly: outcome and complications after locking plate fixation. Musculoskelet Surg. 2012; 96(suppl 1):S3–S11
10.1007/s12306-012-0181-8 . Crossref Medline, Google Scholar - 9.Siwach R, Singh R, Rohilla RK, Kadian VS, Sangwan SS, Dhanda M. Internal fixation of proximal humeral fractures with locking proximal humeral plate (LPHP) in elderly patients with osteoporosis. J Orthop Traumatol. 2008; 9(3):149–153
10.1007/s10195-008-0014-6 . Crossref Medline, Google Scholar - 10.Phisitkul P, McKinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma. 2007; 21(2):83–91
10.1097/BOT.0b013e318030df96 . Crossref Medline, Google Scholar - 11.Tadros AM, O’Brien P, Guy P. Fixation of marginal posterior acetabular wall fractures using locking reconstruction plates and monocortical screwsJ Trauma. 2010; 68(2):478–480
10.1097/TA.0b013e3181b28aee . Crossref Medline, Google Scholar - 12.Schwede R, Babovsky H, Kiessling A, Kowarschik R. Measurement of three-dimensional deformation vectors with digital holography and stereophotogrammetry. Opt Lett. 2012; 37(11):1943–1945
10.1364/OL.37.001943 . Crossref Medline, Google Scholar - 13.Grosse M, Buehl J, Babovsky H, Kiessling A, Kowarschik R. 3D shape measurement of macroscopic objects in digital off-axis holography using structured illumination. Opt Lett. 2010; 35(8):1233–1235
10.1364/OL.35.001233 . Crossref Medline, Google Scholar - 14.Ronnholm P, Hyyppa H, Hyyppa J, Haggren H. Orientation of airborne laser scanning point clouds with multi-view, multi-scale image blocks. Sensors (Basel). 2009; 9(8):6008–6027
10.3390/s90806008 . Crossref Medline, Google Scholar - 15.Galantucci LM, Percoco G, Angelelli G, Reverse engineering techniques applied to a human skull, for CAD 3D reconstruction and physical replication by rapid prototyping. J Med Eng Technol. 2006; 30(2):102–111
10.1080/03091900500131714 . Crossref Medline, Google Scholar - 16.Burgstahler C, Trabold T, Kuettner A, Visualization of pulmonary vein stenosis after radio frequency ablation using multi-slice computed tomography: initial clinical experience in 33 patients. Int J Cardiol. 2005; 102(2):287–291
10.1016/j.ijcard.2004.05.034 . Crossref Medline, Google Scholar - 17.Deng K, Wu B, Sun J. The value of three-dimensional helical CT imaging in the diagnosis of maxillofacial fractures [in Chinese]. Hua Xi Yi Ke Da Xue Xue Bao. 2001; 32(1):123–125. Medline, Google Scholar
- 18.Wojcik K, Nowak R, Polak D. The value of computed tomography with 3D reconstruction for the diagnosis of pelvic and spine fractures following a sports injury: a case report [in English, Polish]. Ortop Traumatol Rehabil. 2010; 12(5):459–466. Medline, Google Scholar
- 19.Kolta S, Kerkeni S, Travert C, Variations in vertebral body dimensions in women measured by 3D-XA: a longitudinal in vivo study. Bone. 2012; 50(3):777–783
10.1016/j.bone.2011.12.005 . Crossref Medline, Google Scholar - 20.Vrabec JT, Champion SW, Gomez JD, Johnson RF, Chaljub G. 3D CT imaging method for measuring temporal bone aeration. Acta Otolaryngol. 2002; 122(8):831–835
10.1080/0036554021000028085 . Crossref Medline, Google Scholar - 21.Lysaker M, Osher S, Tai XC. Noise removal using smoothed normals and surface fitting. IEEE Trans Image Process. 2004; 13(10):1345–1357
10.1109/TIP.2004.834662 . Crossref Medline, Google Scholar - 22.Akpan TB, Igiri AO, Singh SP. Greater sciatic notch in sex differentiation in Nigerian skeletal samples. Afr J Med Med Sci. 1998; 27(1–2):43–46. Medline, Google Scholar
- 23.Walker PL. Greater sciatic notch morphology: sex, age, and population differences. Am J Phys Anthropol. 2005; 127(4):385–391
10.1002/ajpa.10422 . Crossref Medline, Google Scholar
