Wang Peng, Zhu Xiaodong, Xu Peng, Zhang Yan, Wang Lubo, Liu Xiangyan, Mu Weidong
Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jing Wu Road, Jinan, 250012 Shandong China.
Department of Orthopaedics, Weihai Municipal Hospital, Weihai, Shandong China.
Springerplus. 2016 Sep 19;5(1):1602. doi: 10.1186/s40064-016-3316-9. eCollection 2016.
The purpose of this study is to assess the advantages of modified ilioinguinal approach in combined surgical exposures for displaced acetabular fractures involving two columns management. 73 patients with displaced acetabular fractures involving two columns underwent open reduction and internal fixation through combined surgical approaches between 2006 and 2014 in our hospital. The modified ilioinguinal approach combined with Kocher-Langenbeck approach group (group A) included 46 patients. The standard ilioinguinal approach combined with Kocher-Langenbeck approach group (group B) included 27 patients. Outcome was assessed in operative time, blood loss, function outcomes and complications. In group A, the average operative time was 123.2 min, and the average blood loss was 586.2 ml. Anatomic reduction was achieved in 39 patients (84.8 %). The functional recovery was good in 37 patients (80.4 %). Complications related to the approach were observed in 10 patients (21.7 %). In group B, the average operative time was 161.5 min, and the average blood loss was 830 ml. Anatomic reduction was achieved in 24 patients (88.9 %). The functional recovery was good in 22 patients (81.5 %). Complications related to the approach were observed in 9 patients (33.3 %). This study demonstrates that both combined approaches permits good postoperative function results for treatment of acetabular fractures involving two columns. However, the modified ilioinguinal approach combined with Kocher-Langenbeck approach provides less operative time, blood loss and complications.
本研究的目的是评估改良髂腹股沟入路在涉及双柱处理的移位髋臼骨折联合手术显露中的优势。2006年至2014年期间，我院73例涉及双柱的移位髋臼骨折患者通过联合手术入路进行切开复位内固定。改良髂腹股沟入路联合Kocher-Langenbeck入路组（A组）包括46例患者。标准髂腹股沟入路联合Kocher-Langenbeck入路组（B组）包括27例患者。对手术时间、失血量、功能结果和并发症进行评估。A组平均手术时间为123.2分钟，平均失血量为586.2毫升。39例患者（84.8%）实现了解剖复位。37例患者（80.4%）功能恢复良好。10例患者（21.7%）观察到与入路相关的并发症。B组平均手术时间为161.5分钟，平均失血量为830毫升。24例患者（88.9%）实现了解剖复位。22例患者（81.5%）功能恢复良好。9例患者（33.3%）观察到与入路相关的并发症。本研究表明，两种联合入路在治疗涉及双柱的髋臼骨折时均能取得良好的术后功能结果。然而，改良髂腹股沟入路联合Kocher-Langenbeck入路的手术时间、失血量和并发症更少。
