Letournel E
Department of Orthopedics, Choisy Medico Surgical Center, Paris, France.
Clin Orthop Relat Res. 1993 Jul(292):62-76.
The ilioinguinal approach was developed in 1965 as an anterior approach to the pelvis and acetabulum. Before this date, the Smith-Petersen incision or a modification of it called the iliofemoral approach provided the only access to the upper part of the anterior column of the acetabulum. In the current study of 195 acetabular fractures, the ilioinguinal approach was used alone in 178 cases (90%) and in combination with the Kocker-Langenbeck as a double incision in 17 cases (10%). There were 39 simple and 156 complex associated fracture patterns. There were two large groups of associated fractures: anterior column posterior hemitransverse (39 fractures) and both column fractures (98 cases). Of these fracture patterns stabilized through the ilioinguinal approach, there was a rate of perfect reduction of 85% and 73%, respectively. Of 70 fractures involving the anterior column, anterior wall, and anterior column posterior hemitransverse, there were 61 perfect reductions (87%). The complication rate was extremely low, without any evidence of external iliac fossa heterotopic ossification. The ilioinguinal approach provides total and complete access to the anterior column from the sacroiliac joint to the pubic symphysis. An experienced acetabular surgeon may achieve excellent results even with complex fracture patterns.
髂腹股沟入路于1965年被开发出来，作为一种用于骨盆和髋臼的前路入路。在此之前，史密斯-彼得森切口或其改良切口（即髂股入路）是进入髋臼前柱上部的唯一途径。在当前这项对195例髋臼骨折的研究中，178例（90%）单独使用了髂腹股沟入路，17例（10%）将其与科克尔-朗根贝克入路联合作为双切口使用。有39例简单骨折和156例复杂骨折合并模式。有两大组合并骨折：前柱后半横行骨折（39例骨折）和双柱骨折（98例）。在通过髂腹股沟入路固定的这些骨折模式中，完美复位率分别为85%和73%。在70例累及前柱、前壁和前柱后半横行的骨折中，有61例完美复位（87%）。并发症发生率极低，没有任何髂窝异位骨化的证据。髂腹股沟入路提供了从骶髂关节到耻骨联合的前柱的全面且完整的显露。即使对于复杂的骨折模式，经验丰富的髋臼外科医生也可能取得优异的结果。
