A novel plate design for anatomic reduction of posterior acetabular column and wall fractures: A retrospective comparative study of the Paseos plate versus the pelvic reconstruction plate

This study endeavors to compare the clinical and radiological outcomes of 2 different types of plate fixation for posterior acetabular wall and/or column fractures, transverse and posterior wall fractures. We designed an anatomical plate that is easy to apply for acetabular posterior wall and column fractures and can simultaneously fix the column and wall as support with the buttressing effect. Weight-bearing and bending biomechanical tests were performed for the development of the plate. The 39 acetabular fractures operated between January 2013 and June 2017 were divided into 2 groups. Group 1 (n = 17) received treatment using the Paseos anatomical plate, while Group 2 (n = 22) with conventional reconstruction plates. Merle d’Aubigné and Postel score and Matta reduction criteria were utilized for the functional and radiological evaluations. According to Matta reduction criteria, in Group 1, anatomical reduction was achieved in 14 patients (82.3%), good reduction in 2 patients (11.7%), and poor reduction in 1 patient (5.9%). In Group 2, anatomical reduction was observed in 19 patients (86.4%), good reduction in 2 patients (9.1%), and poor reduction in 1 patient (4.5%). At the 12-month follow-up, functional outcomes were evaluated using Merle d’Aubigné and Postel scoring system. In Group 1, excellent scores were recorded in 13 patients (76.4%), good scores in 3 patients (17.6%), and fair scores in 1 patient (5.9%). In Group 2, excellent scores were observed in 19 patients (86.4%), good scores in 2 patients (9.1%), and fair scores in 1 patient (4.5%). The median operation duration in Group 1 was significantly lower than Group 2 ( P  < .001). Paseos plate demonstrated clinical and radiological outcomes comparable to conventional reconstruction plates. Due to its special anatomical structure, it can support a wide bony area with its buttress effect and also it can be applied directly without the need for reshaping during surgery, thus shortening the surgical duration.