改良Stoppa入路治疗髋臼前柱前壁骨折的临床效果

Clinical Effect of the Modified Stoppa Approach in the Treatment of Acetabular Anterior Column and Anterior Wall Fracture

目的:探讨改良Stoppa入路对髋臼前柱前壁骨折患者手术一般情况、骨折复位优良率、髋功能恢复情况及并发症的影响。方法:选取中国人民解放军联勤保障部队第九〇〇医院仓山院区2019年4月-2021年10月收治的75例髋臼前柱前壁骨折行骨折内固定术患者,按照随机数字表法分为甲组(38例,采用改良Stoppa入路)、乙组(37例,采用髂腹股沟入路),并对两组手术一般情况、骨折复位优良率、髋功能恢复情况、并发症发生率进行比较。结果:甲组手术时间[(151.74±32.56)min]、切口长度[(9.53±1.52)cm]均短于乙组[(172.68±33.09)min、(10.54±1.57)cm],出血量[(482.91±49.63)ml]少于乙组[(507.64±49.85)ml],差异均有统计学意义(P<0.05);甲组骨折复位优良率(92.11%)与乙组(89.19%)比较,差异无统计学意义(P>0.05);两组髋功能恢复情况比较,差异无统计学意义(P>0.05);甲组并发症发生率(7.89%)低于乙组(27.03%),差异有统计学意义(P<0.05)。结论:对于髋臼前柱前壁骨折实施骨折内固定术患者,改良Stoppa和髂腹股沟两种入路均具有良好的骨折复位效果,且不影响髋关节功能的恢复,然而改良Stoppa入路切口较小,可减少术中失血及手术用时,并预防并发症发生的风险。

Objective:To investigate the effect of modified Stoppa approach on the general condition of operation,the excellent and good rate of fracture reduction,the recovery of hip function and complications in patients with acetabular anterior column and anterior wall fracture.Method:A total of 75 patients with fracture of anterior wall of acetabular anterior column underwent internal fixation in Cangshan Hospital of the 900th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army from April 2019 to October 2021 were selected.According to the random number table method,they were divided into group A(38 cases,used the modified Stoppa approach)and group B(37 cases,used the ilioinguinal approach).The general conditions of the operation,the excellent and good rate of fracture reduction,the recovery of hip function and the incidence of complications were compared between the two groups.Result:In group A,the operation time[(151.74±32.56)min],the incision length[(9.53±1.52)cm]were shorter than those in the group B[(172.68±33.09)min,(10.54±1.57)cm],the bleeding volume[(482.91±49.63)ml]was less than that in the group B[(507.64±49.85)ml](P<0.05).The excellent and good rate of fracture reduction in group A(92.11%)was not significantly different from that in the group B(89.19%)(P>0.05).There was no significant difference in hip function recovery between the two groups(P>0.05).The incidence of complications in the group A(7.89%)was lower than that in the group B(27.03%)(P<0.05).Conclusion:For patients with acetabular anterior column and anterior wall fractures who underwent fracture internal fixation,both the modified Stoppa and ilioinguinal approaches have good fracture reduction effects,and do not affect the recovery of hip function.However,the modified Stoppa approach has a small incision,which can reduce intraoperative blood loss and operation time,and prevent the risk of complications.