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采用改良Stoppa入路治疗老年髋臼骨折:技术、技巧及陷阱的综述文章

Treatment of Geriatric Acetabular Fractures Using the Modified Stoppa Approach: A Review Article of Technique, Tips, and Pitfalls.

作者信息

Bartosik Mikolaj, Mayr Eckart, Culemann Ulf

机构信息

Department of Trauma Surgery, General Hospital Celle, 29223 Celle, Germany.

Department of Orthopaedics, General Hospital Celle, 29223 Celle, Germany.

出版信息

J Clin Med. 2024 Oct 1;13(19):5867. doi: 10.3390/jcm13195867.

Abstract

The surgical treatment of geriatric acetabular fractures is becoming increasingly important due to a demographic change in age. While acetabular fractures used to occur more frequently in younger patients, they are currently more prevalent in geriatric patients. This change has also led to an increase in the frequency of anterior and combined anterior acetabular fractures. Surgery for geriatric acetabular fractures is very challenging, and surgeons need years of experience to be able to deal with the advantages and disadvantages of pelvic surgery. This is why a high level of surgical expertise is required. The aim of this article is to provide an insight into the topic of geriatric acetabular fractures with a critical narrative review of the current literature and a focus on minimally invasive surgical treatment using the modified Stoppa approach without patients' own assessment. The modified Stoppa approach offers excellent visibility of the anterior structures of the acetabulum and can address the quadrilateral surface effectively. Pelvic surgery, in particular acetabular surgery, offers patients many advantages, such as rapid mobilization and the quick relief of pain symptoms. Total hip arthroplasty is currently being discussed as an alternative with good results for certain types of acetabular fractures in older patients, though it requires clarification of studies and recommendations.

摘要

由于年龄结构的变化,老年髋臼骨折的外科治疗变得越来越重要。髋臼骨折过去在年轻患者中更为常见,而目前在老年患者中更为普遍。这种变化也导致了髋臼前柱骨折和髋臼前柱合并骨折的发生率增加。老年髋臼骨折的手术极具挑战性,外科医生需要多年的经验才能应对骨盆手术的利弊。这就是为什么需要高水平的手术专业知识。本文旨在通过对当前文献进行批判性叙述性综述,并重点关注使用改良Stoppa入路的微创外科治疗(无需患者自身评估),深入探讨老年髋臼骨折这一主题。改良Stoppa入路能很好地显露髋臼前部结构,并能有效处理四边形面。骨盆手术,尤其是髋臼手术,为患者带来诸多益处,如快速活动和疼痛症状的快速缓解。目前正在讨论全髋关节置换术作为老年患者某些类型髋臼骨折的替代方案,效果良好,不过这需要研究和建议的进一步明确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d9/11478202/72ba08f10f7f/jcm-13-05867-g001.jpg

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