比较经腹直肌外侧入路与改良Stoppa入路治疗髋臼骨折的临床疗效

Comparison of the clinical efficacy of pararectus approach and modified Stoppa approach in treatment of acetabular fracture fixation

目的比较经腹直肌外侧切口入路与改良Stoppa切口入路治疗髋臼骨折的临床疗效。方法回顾性分析2013年1月至2018年1月荆州市第三人民医院创伤骨科手术治疗的72例髋臼骨折患者的临床资料,其中运用经腹直肌外侧切口入路(Pararectus approach, PRA)治疗患者38例(PRA组),改良Stoppa切口入路(Modified Stoppaapproach, MSA)治疗患者34例(MSA组)。比较两组的前方入路显露时间、手术的出血量(术中+术后引流)、骨折复位情况,髋关节功能等临床指标。结果两组手术切口显露时间,显露过程出血量及术后引流血量,两组髋关节功能评分差异均无统计学意义(P>0.05)。两组术后影像学复位评估(PRA组优20例,良13例,可5例;MSA组优19例,良11例,可4例)差异无统计学意义(P>0.05)。结论经腹直肌外侧入路与改良Stoppa入路均是治疗髋臼前方骨折理想入路,但是腹直肌外侧入路在手术视野显露上稍有优势。

Objective To compare the clinical efficacy of pararectus approach and modified Stoppa approach in treatment of acetabular fracture fixation.Methods A retrospective analysis was performed on the data of acetabular fracture patients72 cases between January 2013 and January 2018 in of Jingzhou third people’s Hospital.Including 38 cases of pararectus approach(Group PRA),34 cases of modified Stoppa approach(Group MSA).The two groups were compared with respect to operation time,operative skills,blood loss at surgery,fracture reduction,and related to the approach.Results Tow groups were surgical exposure time,blood loss and postoperative hip joint function score,the differences had no statistical significance(P>0.05).Radiographic resetting evaluation was performed in both groups(20 excellent cases,13 good cases and 5 good cases in PRA group).There were 19 excellent cases,11 good cases and 4 cases in MSA group.The difference was not statistically significant(P>0.05).Conclusion The pararectus approach and modified Stoppa approach are both ideal approaches in treatment of acetabular fracture fixation,but the pararectus approach has a slight advantage in the exposure of surgical field.