改良腹直肌旁入路与改良Stoppa入路治疗髋臼骨折临床疗效比较

Comparison of clinical efficacy of modified Stoppa approach and modified pararecutus abdominis approach in the treatment of acetabulum fractures

目的探讨改良腹直肌旁入路与改良Stoppa入路手术治疗髋臼骨折的临床疗效差异。方法回顾2020年1月至2022年1月我院完成的22例髋臼骨折手术,其中改良腹直肌旁入路13例(实验组),改良Stoppa入路9例(对照组),比较两组性别、年龄、受伤至手术时间、骨折分型、手术时间、术中出血量、术后Matta评分及髋关节功能评分。结果两组患者术前一般资料无统计学差异(P>0.05),具有可比性;骨折复位优良率及髋关节功能优良率无统计学差异(P>0.05)。实验组手术时间(124.54±52.21)min,术中出血量(318.46±65.68)mL,均优于对照组(175.00±59.28)min,(403.33±98.62)mL,P<0.05。结论相较于改良Stoppa入路,采用改良腹直肌旁入路手术治疗髋臼骨折可减少手术时间及出血量。

Objective To investigate the clinical effect of the modified Stoppa approach and modified pararecutus abdominis approach in the treatment of acetabular fractures.Methods A retrospective study was performed to analyze the clinical data of 22 operated patients with acetabular fractures in our hospital from January 2020 to January 2022.Among them,13 cases were operated with the modified pararecutus abdominis approach(experimental group)and 9 cases were operated with the modified Stoppa surgical approach(control group).The gender,age,time from injury to operation,fracture typing,operation time,blood loss during operation,postoperative Matta score and hip function score were recorded and compared between the two groups.Results The general preoperative data of the two groups were not statistically significant(P>0.05)and were comparable.There was no significant difference in the rate of excellent quality of fracture reduction and the rate of excellent hip function between the two groups(P>0.05).In the control group,the operative time was(175.00±59.28)min,and the intraoperative blood loss was(403.33±98.62)ml.The operative time of the experimental group was(124.54±52.21)min and the intraoperative bleeding was(318.46±65.68)ml,both were better than those of the control group(P<0.05).Conclusions Compared with the modified Stoppa surgical approach,surgical treatment of acetabular fractures with the modified pararecutus abdominis approach reduces operative blood loss and operative time.It is a reliable treatment for pelvic acetabular fractures through the anterior approach.