Prospective Randomized Controlled Trial Of W-shaped Angular Plate Versus Reconstruction Plate For Posterior Wall Acetabular Fractures

Objective: Traditionally,surgical fixation of posterior wall acetabular fractures is accomplished with one or more pelvic reconstruction plates alone or in combination with spring plates.To spare spring plate and make procedure convenient,we now introduce a new designed device and compare the mid-term outcomes after fixation of acetabular posterior wall fractures using either a W-shaped angle plate(WAP)or a conventional reconstruction plate(RP)with a minimum 1-year follow-up.Methods: We performed a prospective,randomized controlled trial that included 55 adult patients treated with either a WAP(n = 29)or an RP(n = 26).Demographic details,surgical details,duration of hospitalization,surgeryrelated complications,and final functional and radiological outcomes were recorded and assessed over a 12-month period.Results: All fractures in both groups healed uneventfully.We found no statistically significant difference between the groups in length of hospital stay or incidence of complications.At 1 year,there was no evidence of difference in final radiological outcome or functional evaluation between the groups.However,operation time(133.7±31.1 min),blood loss(562.1±290.8 ml),fluoroscopy time(15.9±2.7 s),and screw misplacement rate(6.9%)in the WAP group were significantly lower than those in the RP group(181.9±37.4 min,823.1±258.2 ml,31.4±3.3 s,and 38.5%,respectively;P < 0.05).Conclusions: Our findings suggest that a WAP is a reliable and acceptable option to treat posterior wall fracture of the acetabulum.WAPs were associated with shorter operation and fluoroscopy times,lower rate of screw misplacement,and less blood loss than RPs.