新型改良Stoppa入路治疗髋臼并同侧骨盆骨折效果

MODIFIED STOPPA APPROACH FOR ACETABULAR AND IPSILATERAL PELVIC FRACTURES:ITS CLINICAL EFFECT

目的观察不同入路方法治疗髋臼骨折并同侧骨盆骨折的临床效果。方法髋臼骨折并同侧骨盆骨折病人102例,随机分为两组,各51例。对照组采用传统髂腹股沟入路复位内固定治疗,观察组采用新型改良Stoppa入路复位内固定治疗,比较两组手术时间、手术切口长度、术中出血量、Matta评分、Merled评分、Harris评分以及术后并发症。结果观察组手术时间、手术切口长度和术中出血量均显著低于对照组,差异有显著性（t=3.628~37.137,P〈0.05）。两组Matta评分比较差异无显著性（P〉0.05）。观察组Merled评分、Harris评分均高于对照组,差异有显著性（t=8.216、11.947,P〈0.01）。观察组术后并发症发生率显著低于对照组,差异有显著性（χ^2=5.718,P〈0.05）。结论与传统髂腹股沟入路比较,应用新型改良Stoppa入路复位内固定治疗髋臼骨折并同侧骨盆骨折临床效果较好,并发症少。

Objective To investigate the clinical effectiveness of different approaches for combined acetabular and ipsilateral pelvic fractures（CAIPF）. Methods Patients with CAIPF（n=102）were selected and evenly randomized to observation group and control group.Patients in the control group received the traditional ilioinguinal conduct internal fixation,and those in the observation group treated with modified Stoppaapproach for internal fixation.A comparison was done between the two groups in terms of the following items：operation time,length of incision,amount of bleeding at surgery,Matta score,Merled score,Harris score,and postoperative complications. Results Operation time,length of incision and blood loss in the observation group were significantly lower than that in the control group（t=3.628-37.137,P〈0.05）.The difference in Matta score between the two groups was not significant（P〉0.05）.The scores of Merle score and Harris score were higher in the observation group versus that in the control group（t=8.216,11.947;P〈0.01）.The incidence of postoperative complications was much lower in the observation group versus the control（χ^2=5.718,P〈0.05）. Conclusion Compared with the traditional inguinal approach,application of modified Stoppaapproach in the treatment of combined acetabular and ipsilateral pelvic fractures can get a better result with less complications.