Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA.
J Orthop Trauma. 2021 Oct 1;35(10):523-528. doi: 10.1097/BOT.0000000000002061.
To compare rates of heterotopic ossification (HO) after acetabular fracture surgery, through a posterior approach, with and without gluteus minimus muscle (GMM) debridement.
Retrospective comparative study.
Single academic Level I trauma center.
Ninety-four patients in the GMM preserved group and 42 patients in the GMM debrided group met inclusion criteria.
GMM preservation or debridement during acetabular fracture surgery through a single-posterior approach.
Primary outcomes were incidence and severity of HO. Reoperation for HO excision was assessed. Other risk factors for severe HO (Brooker class III-IV) were secondarily assessed using multivariable logistic regression analyses. Odds ratios (ORs) with 95% confidence intervals were calculated. The significance was set at P-value ≤ 0.05.
There was no difference in the incidence or severity of HO between the debrided and preserved groups. Rates of reoperation for HO excision were comparable. American Society of Anesthesiologists physical status class (OR = 3.3), head injury (OR = 4.6), and abdominal injury (OR = 4.5) were associated with severe HO.
GMM debridement was not associated with a decreased incidence of HO after acetabular fracture surgery. American Society of Anesthesiologists class is a novel risk factor associated with severe HO formation.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
比较通过后入路行髋臼骨折手术时保留和切除臀小肌（GMM）对术后异位骨化（HO）发生率的影响。
回顾性比较研究。
单家学术性一级创伤中心。
符合纳入标准的 GMM 保留组患者 94 例和 GMM 切除组患者 42 例。
通过单一后入路行髋臼骨折手术时保留或切除 GMM。
主要结局指标为 HO 的发生率和严重程度。评估 HO 切除的再手术情况。使用多变量逻辑回归分析评估其他严重 HO（Brooker 分级 III-IV）的危险因素。计算比值比（OR）及其 95%置信区间。P 值≤0.05 为差异有统计学意义。
切除组和保留组的 HO 发生率和严重程度无差异。HO 切除的再手术率相当。美国麻醉医师协会身体状况分级（OR=3.3）、头部损伤（OR=4.6）和腹部损伤（OR=4.5）与严重 HO 相关。
髋臼骨折手术后切除臀小肌与 HO 发生率降低无关。美国麻醉医师协会分级是与严重 HO 形成相关的新的危险因素。
治疗性研究，III 级。欲了解完整的证据分级说明，请参见作者须知。
