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改良Stoppa 入路治疗双侧髋臼骨折:两年临床结果。

Fixation of bilateral acetabular fractures using the modified Stoppa approach: Two-year clinical outcomes.

机构信息

Muğla Sıtkı Koçman Üniversitesi Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 48000 Menteşe, Muğla, Türkiye.

出版信息

Jt Dis Relat Surg. 2022;33(3):624-630. doi: 10.52312/jdrs.2022.858. Epub 2022 Oct 21.

Abstract

OBJECTIVES

This study aims to evaluate the two-year clinical results of bilateral acetabular fractures operated via a single incision with the modified Stoppa approach.

PATIENTS AND METHODS

Between January 2013 and January 2020, a total of 22 acetabular fractures of 11 patients (7 males, 4 females; mean age: was 42.9±13.7 years; range, 19 to 62 years) who were operated via the modified Stoppa approach were retrospectively analyzed. The medical records were analyzed in terms of time to surgery, fracture patterns, Injury Severity Score (ISS), operation duration, blood loss, reduction quality, perioperative complications and concomitant injuries. Reduction quality was assessed according to Matta's criteria. The Harris Hip Score (HHS) and modified Merle d'Aubigne score (MDS) were utilized for functional assessment.

RESULTS

The mean follow-up was 49±15 (range, 30 to 79) months. The mean ISS was 28.2±7.2. The mean modified MDS was 15.90±1.57. The mean HHS was 84.27±8.85. For both sides, reduction was anatomical-anatomical (63.6%) in seven patients, anatomical-imperfect in three (27.3%) patients, and imperfectpoor in one (9.1%) patient. According to the Kellgren-Lawrence radiological evaluation at 24 months of follow-up bilaterally, Grade 0-1 osteoarthritis was observed in six (54.5%) patients, Grade 1-1 in four (36.4%) patients, and Grade 1-2 osteoarthritis in one (9.1%) patient.

CONCLUSION

The modified Stoppa approach in bilateral acetabular fractures seems to be more preferable than other approaches, as it can be performed with a single incision and provides less bleeding, shorter operation duration, and satisfactory results.

摘要

目的

本研究旨在评估经改良Stoppa 入路单一切口双侧髋臼骨折术后 2 年的临床疗效。

方法

回顾性分析 2013 年 1 月至 2020 年 1 月采用改良 Stoppa 入路治疗的 11 例(7 例男性,4 例女性;平均年龄 42.9±13.7 岁;19~62 岁)双侧髋臼骨折患者的临床资料。分析患者的手术时间、骨折分型、损伤严重度评分(ISS)、手术时间、出血量、复位质量、围手术期并发症及合并伤等。复位质量评估采用 Matta 标准,髋关节功能采用 Harris 评分(HHS)和改良 Merle d'Aubigne 评分(MDS)评估。

结果

患者平均随访 49±15(3079)个月,ISS 平均 28.2±7.2,改良 MDS 平均 15.90±1.57,HHS 平均 84.27±8.85。双侧髋臼骨折复位质量均为解剖复位-解剖复位 63.6%,解剖复位-不满意复位 27.3%,不满意复位-差复位 9.1%。术后 24 个月双侧髋臼 Kellgren-Lawrence 放射学评估,01 级骨关节炎 54.5%,11 级骨关节炎 36.4%,12 级骨关节炎 9.1%。

结论

经改良 Stoppa 入路治疗双侧髋臼骨折较其他入路更具优势,因为它可以通过单一切口完成,出血量少,手术时间短,效果满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb11/9647675/042ac9402f44/JDRS-2022-33-3-624-630-F1.jpg

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