应用改良Stoppa入路手术治疗骨盆髋臼骨折的疗效分析

Application of modified Stoppa approach in treatment of pelvic and acetabular fractures

目的 探讨应用改良Stoppa入路手术治疗骨盆、髋臼骨折的手术方法及疗效。方法 笔者回顾分析自2010-01—2014-12应用改良Stoppa入路手术治疗的48例骨盆、髋臼骨折的临床资料,其中骨盆骨折34例,髋臼骨折14例。结果所有患者获随访6个月-5年,平均24个月。本组手术切口长度（9.2±2.7）cm,手术时间（1.7±0.7）h,出血量（545±230）ml。术后X线片示骨折复位满意,末次随访时疗效根据Matta功能评分标准评定：优36例,良10例,可2例,优良率95.8%。1例术中发生膀胱破裂,1例术后发生深静脉血栓,无切口感染、骨折不愈合、股外侧皮神经麻痹、腹股沟疝及医源性血管神经损伤等并发症发生。结论 改良Stoppa入路手术治疗骨盆髋臼骨折具有操作安全、创伤小、视野清晰、骨折易于复位及固定、疗效可靠、并发症少等优点,具有一定的临床应用价值。

Objective To investigate the application of modified Stoppa approach in the treatment of pelvic and acetabular fractures. Methods Forty eight cases of pelvic and acetabular fractures in our department from January 2010 to December 2014 were retrospectively analyzed, including 34 cases of pelvic fractures and 14 cases of acetabular fractures. Results All patients were followed up for 6 months to 5 years（average, 24 months）. The incision length was （9.2±2.7）cm, the operation time and blood loss were （1.7±0.7）h and （545±230）ml respectively. The postoperative X-ray showed satisfactory reduction of fractures. According to the Matta functional scoring criteria： the result was excellent in 36 cases, good in 10 cases, fair in 2 cases, the excellent and good rate was 95.8%. There was 1 case of vesical rupture, 1 case of deep vein thrombosis, and no other complications were found. Conclusion The modified Stoppa approach has advantages of mini-invasiveness, less blood loss, sufficient exposure, and less complications. We recommend the use of this approach in the treatment of pelvic and acetabular fractures.