Department of Orthopaedics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Orthop Surg. 2021 Jun;13(4):1191-1195. doi: 10.1111/os.12970. Epub 2021 May 4.
To compare the clinical efficacy of pararectus and ilioinguinal approach in the treatment of acetabular fractures.
A retrospective analysis of the clinical data of 60 patients with acetabular fractures treated by the pararectus approach or the ilioinguinal approach from January 2016 to January 2019 was performed to record all data by comparing the length of the surgical incision, the time to expose the fracture and the amount of blood loss during the operation. Patients were routinely followed up at 1, 6 and 12 months postoperatively. The function of the hip joint after the operation (Improved Merle d' Aubigne and Postel scores) and the complications postoperation were recorded.
There was a significant difference (mean ± SD) in the length of surgical incision [(11.2 ± 1.5) cm vs.(23.8 ± 2.1) cm], and in surgical exposure time [(10.8 ± 1.7) min vs.(19.9 ± 1.9) min] (P < 0.05) between the two approaches; there was no significant difference (mean ± SD) in intraoperative blood loss [(591.8 ± 131.4) mL vs. (614.6 ± 132.7) mL] or in hip function scores at the last follow-up between the two groups (P > 0.05). In the pararectus approach group, there was one patient (3.3%) with postoperative wound fat liquefaction, and the wound completely improved by secretion culture, enhanced dressing and effective antibiotics, one patient (3.3%) developed lateral femoral cutaneous nerve injury; One case (3.3%) of postoperative myositis ossificans occurred in the ilioinguinal approach group, and there were no obvious symptoms.
These data suggest that for patients with acetabular fractures, both the pararectus approach and the ilioinguinal approach can achieve satisfactory surgical results, but the former has relatively simple operation and small incision length, which is in line with the modern concept of the minimally invasive pelvis.
比较腹直肌旁入路和髂腹股沟入路治疗髋臼骨折的临床疗效。
回顾性分析 2016 年 1 月至 2019 年 1 月采用腹直肌旁入路或髂腹股沟入路治疗的 60 例髋臼骨折患者的临床资料，比较手术切口长度、骨折显露时间和术中出血量。术后常规随访 1、6、12 个月，记录术后髋关节功能（改良 Merle d' Aubigne 和 Postel 评分）及术后并发症。
两组手术切口长度[（11.2±1.5）cm 比（23.8±2.1）cm]、手术显露时间[（10.8±1.7）min 比（19.9±1.9）min]比较，差异均有统计学意义（P<0.05）；术中出血量[（591.8±131.4）ml 比（614.6±132.7）ml]、末次随访髋关节功能评分比较，差异均无统计学意义（P>0.05）。腹直肌旁入路组术后切口脂肪液化 1 例（3.3%），经分泌物培养、加强换药、有效抗生素治疗后切口完全愈合；股外侧皮神经损伤 1 例（3.3%）；髂腹股沟入路组术后发生异位骨化 1 例（3.3%），无明显症状。
对于髋臼骨折患者，腹直肌旁入路和髂腹股沟入路均可获得满意的手术效果，但前者手术操作相对简单，切口长度小，符合微创骨盆的现代理念。
