Ravanbod Hadi, Alikhani Behnam, Baniasadi Mojtaba, Masoumi Hosein
Department of Orthopedic Surgery, School of Medicine, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
J Orthop. 2024 May 11;61:61-65. doi: 10.1016/j.jor.2024.05.003. eCollection 2025 Mar.
Acetabulum fractures pose significant challenges in orthopedic trauma due to anatomical complexity and the potential for iatrogenic injury to surrounding structures. The study aims to compare the outcomes of two surgical approaches, the ilioinguinal approach (IA) and the modified Stoppa approach (MSA), in managing acetabular fractures.
A retrospective cohort study was conducted on 50 patients with anterior acetabular fractures. Demographic characteristics and perioperative data were collected, and the patients were categorized based on the applied surgical approach, either IA or MSA. Statistical tests were used for data analysis.
The MSA group showed significantly lower intraoperative blood loss compared to IA (MSA: 404.36 ± 151.94 ml, IA: 650.92 ± 136.33 ml, Δ = 246.56 ml, P < 0.001). The mean procedure duration for MSA was 141.88 ± 27.12 min, compared to 172.24 ± 32.69 min for IA (P = 0.37). The incidence of soft tissue infection (MSA: 8 %, IA: 8 %) and sciatic nerve injury (both 0 %) exhibited no significant differences (P > 0.99). Postoperative assessments, Harris Hip Scores (MSA: 90.08 ± 6.26, IA: 89.29 ± 6.64, P = 0.66) and Modified Merle d'Aubigné Scores (MSA: 14.86 ± 1.37, IA: 15.23 ± 1.16, P = 0.40), showed no substantial variance between groups.
The study suggests that the MSA approach demonstrated superiority, particularly due to significantly less intraoperative blood loss. Further comprehensive studies are recommended to validate and generalize these findings.
髋臼骨折因解剖结构复杂以及对周围结构存在医源性损伤风险,给骨科创伤治疗带来重大挑战。本研究旨在比较两种手术方法,即髂腹股沟入路(IA)和改良Stoppa入路(MSA),在治疗髋臼骨折方面的疗效。
对50例髋臼前部骨折患者进行回顾性队列研究。收集人口统计学特征和围手术期数据,并根据所采用的手术方法(IA或MSA)对患者进行分类。使用统计检验进行数据分析。
与IA组相比,MSA组术中失血量显著更低(MSA:404.36±151.94毫升,IA:650.92±136.33毫升,差值=246.56毫升,P<0.001)。MSA组的平均手术时间为141.88±27.12分钟,而IA组为172.24±32.69分钟(P=0.37)。软组织感染发生率(MSA:8%,IA:8%)和坐骨神经损伤发生率(均为0%)无显著差异(P>0.99)。术后评估,Harris髋关节评分(MSA:90.08±6.26,IA:89.29±6.64,P=0.66)和改良Merle d'Aubigné评分(MSA:14.86±1.37,IA:15.23±1.16,P=0.40),两组之间无实质性差异。
该研究表明,MSA入路显示出优势,尤其是术中失血量显著更少。建议进行进一步的综合研究以验证并推广这些发现。