Chen Kaifang, Ji Yanhui, Huang Zhenfei, Navinduth Ramphul, Yang Fan, Sun Tingfang, Xiong Zekang, Yao Sheng, Ahn Jaimo, Guo Xiaodong
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
J Orthop Trauma. 2018 Nov;32(11):e428-e434. doi: 10.1097/BOT.0000000000001303.
To report the technical aspects, radiographic results, and complications of a modified ilioinguinal approach for the treatment of bicolumnar acetabular fractures, especially involving the quadrilateral plate.
Retrospective review.
Level I Trauma Center, Wuhan Union Hospital, China.
PATIENTS/PARTICIPANTS: Data from all acetabular fractures (n = 96) treated surgically were collected between January 2012 and June 2015. According to the exclusion criteria, 22 patients who had undergone a single supra-ilioinguinal approach with a minimum of 1-year follow-up were included in the study.
The supra-ilioinguinal approach was used to treat bicolumnar acetabular fractures by modifying the ilioinguinal approach, using the navel, anterior superior iliac spine, and the symphysis pubis as landmarks.
The surgical exposure and reduction of fractures is expected to become more direct and convenient, with shorter surgical time, less blood loss, and fewer complications.
Of the 22 consecutive patients, 5 were anterior column with posterior hemi-transverse, 11 were associated both column, 3 were transverse and 3 were T-type patterns. Average length of incision, operative time, and intraoperative blood loss were 10.7 ± 1.1 cm, 182 ± 40 minutes, and 793 ± 228 mL, respectively. Seventeen cases of the reductions were graded excellent; 4, good; and 1, poor. In the last follow-up, the Merle d 'Aubigné scores showed that 14 cases were excellent; 6, good; and 2, poor. Postoperative deep vein thrombosis occurred in 1 patient and lateral femoral cutaneous nerve injury in 3 patients.
For the treatment of bicolumnar acetabular fractures, the supra-ilioinguinal approach provides direct visualization and convenient access to the quadrilateral plate, and allows for appropriate reduction and fixation with few complications.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
报告改良髂腹股沟入路治疗双柱髋臼骨折，尤其是累及四边形板骨折的技术要点、影像学结果及并发症。
回顾性研究。
中国武汉协和医院一级创伤中心。
患者/参与者：收集2012年1月至2015年6月期间所有接受手术治疗的髋臼骨折患者（n = 96）的数据。根据排除标准，22例接受单一改良髂腹股沟入路且至少随访1年的患者纳入本研究。
采用改良髂腹股沟入路，以肚脐、髂前上棘和耻骨联合为标志，治疗双柱髋臼骨折。
预期手术显露和骨折复位更直接、方便，手术时间更短，失血更少，并发症更少。
22例连续患者中，5例为前柱伴后半横行骨折，11例为双柱骨折，3例为横行骨折，3例为T型骨折。平均切口长度、手术时间和术中失血量分别为10.7±1.1 cm、182±40分钟和793±228 mL。17例复位评为优；4例为良；1例为差。末次随访时，Merle d'Aubigné评分显示14例为优；6例为良；2例为差。术后1例发生深静脉血栓形成，3例发生股外侧皮神经损伤。
对于双柱髋臼骨折的治疗，改良髂腹股沟入路可直接显露四边形板，方便操作，能实现恰当复位和固定，并发症少。
治疗性四级。有关证据水平的完整描述见作者须知。
