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本文引用的文献

1
A comparison between ilioinguinal and modified Stoppa approach in anterior column acetabular fractures.髂腹股沟与改良Stoppa 入路治疗前柱髋臼骨折的比较。
Injury. 2024 Feb;55(2):111166. doi: 10.1016/j.injury.2023.111166. Epub 2023 Nov 1.
2
Comparison between ilioinguinal approach and modified Stoppa approach for the treatment of acetabular fractures: An updated systematic review and meta-analysis.髂腹股沟入路与改良 Stoppa 入路治疗髋臼骨折的比较:一项更新的系统评价和荟萃分析。
Orthop Traumatol Surg Res. 2022 Apr;108(2):103204. doi: 10.1016/j.otsr.2022.103204. Epub 2022 Jan 20.
3
The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures.Stoppa 联合髂腹股沟入路治疗双柱髋臼骨折。
J Orthop Surg Res. 2020 Dec 7;15(1):588. doi: 10.1186/s13018-020-02133-3.
4
Clinico-radiological Outcomes of Using Modified Stoppa Approach for Treating Acetabular Fractures: An Institutional Review.采用改良Stoppa入路治疗髋臼骨折的临床影像学结果:一项机构回顾研究
Cureus. 2020 Apr 24;12(4):e7821. doi: 10.7759/cureus.7821.
5
Modified Stoppa as an alternative surgical approach for fixation of anterior fracture acetabulum: a randomized control clinical trial.改良 Stoppa 入路治疗前柱髋臼骨折内固定的随机对照临床试验
J Orthop Surg Res. 2020 Apr 17;15(1):154. doi: 10.1186/s13018-020-01660-3.
6
Long-term total hip arthroplasty rates in patients with acetabular and pelvic fractures after surgery: A population-based cohort study.术后髋臼和骨盆骨折患者的长期全髋关节置换率:一项基于人群的队列研究。
PLoS One. 2020 Apr 3;15(4):e0231092. doi: 10.1371/journal.pone.0231092. eCollection 2020.
7
Epidemiology of pelvic and acetabular fractures in France.法国骨盆和髋臼骨折的流行病学。
Orthop Traumatol Surg Res. 2020 Sep;106(5):831-839. doi: 10.1016/j.otsr.2019.11.019. Epub 2020 Feb 1.
8
Meta-analysis of modified Stoppa approach and ilioinguinal approach in anterior pelvic ring and acetabular fractures.改良Stoppa入路与髂腹股沟入路治疗骨盆前环及髋臼骨折的Meta分析
Medicine (Baltimore). 2020 Jan;99(4):e18395. doi: 10.1097/MD.0000000000018395.
9
The Pararectus Approach in Acetabular Surgery: Radiological and Clinical Outcome.髋臼手术中的腹膜旁入路:放射学和临床结果。
J Orthop Trauma. 2020 Feb;34(2):82-88. doi: 10.1097/BOT.0000000000001636.
10
MODIFIED STOPPA APPROACH FOR PELVIC AND ACETABULAR FRACTURE TREATMENT.改良Stoppa入路治疗骨盆与髋臼骨折
Acta Ortop Bras. 2019 Jul-Aug;27(4):216-219. doi: 10.1590/1413-785220192704188933.

髋臼骨折手术入路的比较分析:失血情况与手术效率

Comparative analysis of surgical approaches in acetabular fractures: Blood loss and procedural efficiency.

作者信息

Ravanbod Hadi, Alikhani Behnam, Baniasadi Mojtaba, Masoumi Hosein

机构信息

Department of Orthopedic Surgery, School of Medicine, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Orthop. 2024 May 11;61:61-65. doi: 10.1016/j.jor.2024.05.003. eCollection 2025 Mar.

DOI:10.1016/j.jor.2024.05.003
PMID:39411508
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11472015/
Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。