Chesser Tim J S, Eardley Will, Mattin Andrew, Lindh Amy M, Acharya Mehool, Ward Anthony J
Pelvic and Acetabular Reconstruction Unit, Trauma and Orthopaedic Department, North Bristol NHS Trust, Bristol, United Kingdom.
J Orthop Trauma. 2015 Feb;29 Suppl 2:S25-8. doi: 10.1097/BOT.0000000000000268.
Traditionally, the anterior surgical approach of choice for acetabular reconstruction was ilioinguinal. There has been an increasing usage of the midline "Stoppa" or "anterior intrapelvic approach." The aim is to report the techniques, early results (minimum 1 year), and complications of anterior approaches for acetabular reconstruction.
Retrospective case-note review.
Pelvic and acetabular tertiary center.
A consecutive series of acetabular fractures treated at 1 tertiary specialist unit were retrospectively reviewed. The fracture patterns, incisions used, intraoperative and postoperative complications, reduction achieved (measured on postoperative radiographs and computed tomography scans), and early postoperative results (minimum 1-year follow-up), were recorded.
Postoperative reduction (measured by postoperative plain radiographs and computed tomography).
Of 160 consecutive patients who underwent acetabular reconstruction, 56 (mean age, 44 years) underwent reconstruction using only anterior approaches (mean of 7 days after injury). Iatrogenic complications, postoperative infection, arthritis, and avascular necrosis rates are comparable with the literature. Overall, anatomic reduction was seen in 71% of cases and concentric reconstruction of the dome in over 90%. Thirty-six of the 56 patients (64%) were symptom-free at the latest follow-up and 34 (61%) had returned to work.
The results reported suggest the use of dual approaches using the lateral 2 windows, and/or a midline anterior intrapelvic approach in anterior acetabular reconstructions has a relatively low complication rate and can lead to anatomic reconstructions in 71%.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
传统上，髋臼重建的首选前路手术方法是髂腹股沟入路。中线“Stoppa”或“前路盆腔内入路”的使用越来越多。目的是报告髋臼重建前路手术的技术、早期结果（至少1年）及并发症。
回顾性病例笔记研究。
骨盆与髋臼三级中心。
回顾性分析在1个三级专科单位连续治疗的一系列髋臼骨折患者。记录骨折类型、使用的切口、术中及术后并发症、复位情况（通过术后X线片和计算机断层扫描测量）以及术后早期结果（至少1年随访）。
术后复位情况（通过术后X线平片和计算机断层扫描测量）。
在160例连续接受髋臼重建的患者中，56例（平均年龄44岁）仅采用前路手术进行重建（受伤后平均7天）。医源性并发症、术后感染、关节炎和缺血性坏死发生率与文献报道相当。总体而言，71%的病例实现了解剖复位，穹顶同心重建率超过90%。56例患者中有36例（64%）在最近一次随访时无症状，34例（61%）已恢复工作。
报告结果表明，在髋臼前路重建中使用外侧两个窗口的双入路和/或中线前路盆腔内入路并发症发生率相对较低，71%的病例可实现解剖重建。
治疗性IV级。有关证据水平的完整描述，请参阅作者指南。
