Liu Wei, Yang Hongbin, Yu Zhenyan, Zhao Yu, Hu Jigong, Li Benyang, Zhu Yechong
Department of Orthopedics, Lu'an Hospital of Chinese Medicine, Lu'an, 237006 Anhui Province China.
Department of Orthopedics, Lu'an Hospital Affiliated to Anhui University of Chinese Medicine, Lu'an, 237006 Anhui Province China.
Indian J Orthop. 2022 Jan 3;56(5):829-836. doi: 10.1007/s43465-021-00585-1. eCollection 2022 May.
Pelvic and acetabular fractures are common orthopedic diseases, and this research was to investigate the therapeutic effects of pararectus and Stoppa approaches in treating complex pelvic acetabular fractures.
The clinical information of patients with pelvic and acetabular fractures treated surgically in Lu'an Hospital of Chinese medicine, China from January 2016 to April 2020 was analyzed. There were 30 cases each in the transabdominal pararectus approach and modified Stoppa approach groups. The operation time, incision length, blood loss, and postoperative complications of both groups were recorded according to the Merle d'Aubigné-Postel hip score. The recovery of hip function was evaluated 6 months after surgery, and the clinical and therapeutic efficacies of the two groups were compared.
The patients were followed up for 6-7 months (average, 6.5 months). The average operation time, incision length, and blood loss in the pararectus and Stoppa approach groups were 180 ± 41.105 min, 8.667 ± 1.373 cm, 259.667 ± 382 mL and 202.667 ± 32.793 min, 11.600 ± 1.958 cm, and 353.667 ± 590 mL, respectively. The satisfactory rate of fracture reduction, excellent and good rate of hip function score, and incidence of complications were 28/30, 27/30, 1/30 and 25/30, 25/30, 3/30, respectively. There were significant differences in operation time, incision length, and blood loss between the two groups ( < 0.05). However, there was no significant difference in the excellent and good rate of hip function score, fracture reduction satisfaction, and complication rate between both groups ( > 0.05).
The pararectus approach can reveal the better anatomical structure of the pelvis and acetabulum, such as the corona mortis and quadrilateral plate, for conducive fracture reduction and fixation. It can also effectively shorten the length of the incision, reduce operative blood loss, and shorten the operation time. It is a better choice for the clinical treatment of complex pelvic and acetabular fractures.
骨盆和髋臼骨折是常见的骨科疾病，本研究旨在探讨经腹直肌旁入路和Stoppa入路治疗复杂骨盆髋臼骨折的疗效。
分析2016年1月至2020年4月在中国六安市中医院接受手术治疗的骨盆和髋臼骨折患者的临床资料。经腹直肌旁入路组和改良Stoppa入路组各30例。根据Merle d'Aubigné-Postel髋关节评分记录两组的手术时间、切口长度、失血量和术后并发症。术后6个月评估髋关节功能恢复情况，比较两组的临床疗效和治疗效果。
患者随访6 - 7个月（平均6.5个月）。经腹直肌旁入路组和Stoppa入路组的平均手术时间、切口长度和失血量分别为180±41.105分钟、8.667±1.373厘米、259.667±382毫升和202.667±32.793分钟、11.600±1.958厘米、353.667±590毫升。骨折复位满意率、髋关节功能评分优良率和并发症发生率分别为28/30、27/30、1/30和25/30、25/30、3/30。两组手术时间、切口长度和失血量差异有统计学意义（<0.05）。然而，两组髋关节功能评分优良率、骨折复位满意度和并发症发生率差异无统计学意义（>0.05）。
经腹直肌旁入路能更好地显露骨盆和髋臼的解剖结构，如死亡冠和四边形板，有利于骨折复位和固定。还能有效缩短切口长度，减少术中失血量，缩短手术时间。是临床治疗复杂骨盆髋臼骨折的较好选择。
