Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyüan, 33302, Taiwan.
Eur J Orthop Surg Traumatol. 2023 May;33(4):829-836. doi: 10.1007/s00590-022-03216-z. Epub 2022 Feb 4.
The pararectus approach is used to treat acetabular fractures; however, it remains unclear whether it can be used to treat pelvic fractures. This study aimed to examine the outcomes of patients with a pelvic ring fracture treated with this approach.
Seven patients with AO B2.2 pelvic fractures treated with the pararectus approach were included. Patients' pain was assessed pre- and postoperatively with a numerical rating scale. Radiological evaluations included inlet and outlet ratios and pelvic symmetry. Functional outcomes, including Merle d'Aubigné and Majeed scores, were also recorded for 12 months.
One patient experienced obturator nerve neuropraxia. Pain scores ranged from 2.3-8.0 to 2.0-3.1 points before and after surgery, respectively. Radiological findings revealed satisfactory outcomes. The maximal gap of the affected ilium reduced from 8.6-20.2 to 0-3.4 mm, from 6.8-17.9 to 0-4.4 mm, and from 3.7-20.3 to 0-3.2 mm in the axial, sagittal, and coronal views, respectively. Based on multiple evaluations, functional outcomes were improved for all patients.
The pararectus approach can be used safely and satisfactorily to treat AO B 2.2 pelvic fractures.
经腹直肌旁入路用于治疗髋臼骨折，但用于治疗骨盆骨折的效果尚不清楚。本研究旨在探讨经腹直肌旁入路治疗骨盆环骨折患者的疗效。
纳入 7 例采用腹直肌旁入路治疗的 AO B2.2 型骨盆骨折患者。采用数字评分量表评估患者术前和术后的疼痛情况。影像学评估包括入口和出口比值以及骨盆对称性。还记录了 12 个月的 Merle d'Aubigné 和 Majeed 评分等功能结果。
1 例患者发生闭孔神经神经损伤。术前疼痛评分为 2.3-8.0 分，术后为 2.0-3.1 分。影像学结果显示疗效满意。受累髂骨的最大间隙在轴位、矢状位和冠状位分别从 8.6-20.2 至 0-3.4mm、从 6.8-17.9 至 0-4.4mm、从 3.7-20.3 至 0-3.2mm 减小。根据多项评估，所有患者的功能结果均得到改善。
经腹直肌旁入路可安全、满意地用于治疗 AO B2.2 型骨盆骨折。
