Treatment of posterior wall acetabular fractures via the direct posterior approach using a seagull-shaped plate: A retrospective cohort study

ObjectiveTo evaluate the clinical efficacy of the direct posterior approach (DPA) with seagull-shaped plate fixation for treating posterior wall acetabular fractures.MethodsA retrospective cohort study of 17 patients (8 male, 9 female) with posterior wall acetabular fractures treated with DPA seagull-shaped plate fixation was conducted. Postoperative pelvic X-ray imaging and computed tomography were performed, and the quality of acetabular reduction was evaluated using the Matta score. The Merle d'Aubigné & Bone score, as modified by Matta, was used to assess hip joint function.ResultsThe mean ± standard deviation surgical incision length, operating time, and intraoperative blood loss were 9.7 ± 0.6 cm, 48.7 ± 9.1 min, and 235.3 ± 65.6 mL, respectively. According to the Matta score, 11 patients achieved excellent reduction quality, and six had good reduction quality, resulting in a 100% combined excellent or good reduction rate. All patients had good fracture healing, with a healing time of 9.7 ± 1.6 weeks. The modified Merle d'Aubigné & Bone score was 17.0 ± 1.6, with 11, 4, 2, and 0 patients rated as excellent, good, fair, and poor, respectively, yielding an 88.2% excellent or good outcome rate. Postoperative complications included fat liquefaction in one patient and deep vein thrombosis in the lower limbs of two patients, with an overall complication rate of 17.6%.ConclusionsDPA with seagull-shaped plate fixation provides satisfactory clinical outcomes for posterior wall acetabular fractures, improving patients' living ability and quality of life.