Purpose： To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures. Methods： Case-controlled tri...Purpose： To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures. Methods： Case-controlled trials （CCTs） published from January 2010 to August 2015 that compared the ilioinguinal approach and Stoppa approach in the management of displaced acetabular fractures were retrieved from the databases of Cochrane Library, Pubmed, CNKI, and so on. Methodological quality of the trials was critically assessed. Statistical software RevMan 5.0 was used for data analysis. Results： Eight articles were included in the meta-analysis. Through comparing the efficacy and safety of ilioinguinal approach and Stoppa approach in the treatment of displaced acetabular fracture, statistical significance was found in the average operation time [WMD = 68.29, 95% CI （10.52, 126.05）, p 〈 0.05] and the median intraoperative blood loss [WMD = 142.26, 95% CI （9.30, 275.23）, p 〈 0.05]. However, there existed no statistical significance in the fracture end reset satisfaction rate [RR = 0.63, 95% CI （0.17, 2.37）, p 〉 0.05], the early complications rate [RR = 0.89, 95% CI （0.33, 2.40）, p 〉 0.05], the late complications rate [RR = 0.91, 95% CI （0.27, 3.01）, p 〉 0.05], and Harris hip score good function rate [RR = 0.52, 95% CI （0.25, 1.10）, p 〉 0.05]. Conclusion： Though both techniques can obtain satisfactory clinical functions in the treatment of displaced acetabular fractures, Stoppa approach is superior to the ilioinguinal approach in terms of operation time and intraoperative blood loss.展开更多
目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入...目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入路病人为B组,选择腹直肌旁入路病人为C组,经倾向性匹配评分法最终得出,A、B组均为50例,C组52例,三组基线资料对比差异无统计学意义(P>0.05)。对比三组一般手术情况、术后住院时间、术后7d骨折复位质量、不同时间点(术前、出院时以及术后6个月末次随访)的髋关节功能(改良Merle D'Aubigne and Postel评分系统)以及术后并发症发生情况。结果:三组显露骨折端时间、术中出血量、术后Hb对比差异有统计学意义(P<0.05),其中B、C组显露时间显著短于A组(P<0.05),术中出血量显著少于A组(P<0.05),术后Hb显著高于A组(P<0.05),B、C组间上述手术指标对比差异无统计学意义(P>0.05);三组术后7d骨折复位质量优良率对比差异无统计学意义(P>0.05),C组的优良率虽高于A、B组,但两两组间对比差异无统计学意义(P>0.05);出院时以及术后6个月末次随访时,三组Postel评分逐渐提高,三组时间点效应对比有统计学意义(P<0.05);三组组间效应以及时间点与组间交互效应对比,差异均无统计学意义(P>0.05),三组出院时及术后6个月末次随访时Postel评分均高于术前(P<0.05);三组术后总并发症率对比差异有统计学意义(P<0.05),其中C组显著低于A组(9.62%vs36.00%,P<0.05)。结论:3种手术入路的钢板内固定术治疗骨盆髋臼骨折均能达到良好骨折复位质量,恢复髋关节功能,但改良Stoppa入路和腹直肌旁入路术中显露时间、出血量及术后Hb效果优于髂腹股沟入路,而腹直肌旁入路的骨折复位优良率高于其他2种入路,且并发症更少。展开更多
基金This study was funded by the National Natural Science Foundation of China {No.81572098） and Natural Science Foundation of Shanxi Province of China （No. 2008012011-3）.
文摘Purpose： To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures. Methods： Case-controlled trials （CCTs） published from January 2010 to August 2015 that compared the ilioinguinal approach and Stoppa approach in the management of displaced acetabular fractures were retrieved from the databases of Cochrane Library, Pubmed, CNKI, and so on. Methodological quality of the trials was critically assessed. Statistical software RevMan 5.0 was used for data analysis. Results： Eight articles were included in the meta-analysis. Through comparing the efficacy and safety of ilioinguinal approach and Stoppa approach in the treatment of displaced acetabular fracture, statistical significance was found in the average operation time [WMD = 68.29, 95% CI （10.52, 126.05）, p 〈 0.05] and the median intraoperative blood loss [WMD = 142.26, 95% CI （9.30, 275.23）, p 〈 0.05]. However, there existed no statistical significance in the fracture end reset satisfaction rate [RR = 0.63, 95% CI （0.17, 2.37）, p 〉 0.05], the early complications rate [RR = 0.89, 95% CI （0.33, 2.40）, p 〉 0.05], the late complications rate [RR = 0.91, 95% CI （0.27, 3.01）, p 〉 0.05], and Harris hip score good function rate [RR = 0.52, 95% CI （0.25, 1.10）, p 〉 0.05]. Conclusion： Though both techniques can obtain satisfactory clinical functions in the treatment of displaced acetabular fractures, Stoppa approach is superior to the ilioinguinal approach in terms of operation time and intraoperative blood loss.
文摘目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入路病人为B组,选择腹直肌旁入路病人为C组,经倾向性匹配评分法最终得出,A、B组均为50例,C组52例,三组基线资料对比差异无统计学意义(P>0.05)。对比三组一般手术情况、术后住院时间、术后7d骨折复位质量、不同时间点(术前、出院时以及术后6个月末次随访)的髋关节功能(改良Merle D'Aubigne and Postel评分系统)以及术后并发症发生情况。结果:三组显露骨折端时间、术中出血量、术后Hb对比差异有统计学意义(P<0.05),其中B、C组显露时间显著短于A组(P<0.05),术中出血量显著少于A组(P<0.05),术后Hb显著高于A组(P<0.05),B、C组间上述手术指标对比差异无统计学意义(P>0.05);三组术后7d骨折复位质量优良率对比差异无统计学意义(P>0.05),C组的优良率虽高于A、B组,但两两组间对比差异无统计学意义(P>0.05);出院时以及术后6个月末次随访时,三组Postel评分逐渐提高,三组时间点效应对比有统计学意义(P<0.05);三组组间效应以及时间点与组间交互效应对比,差异均无统计学意义(P>0.05),三组出院时及术后6个月末次随访时Postel评分均高于术前(P<0.05);三组术后总并发症率对比差异有统计学意义(P<0.05),其中C组显著低于A组(9.62%vs36.00%,P<0.05)。结论:3种手术入路的钢板内固定术治疗骨盆髋臼骨折均能达到良好骨折复位质量,恢复髋关节功能,但改良Stoppa入路和腹直肌旁入路术中显露时间、出血量及术后Hb效果优于髂腹股沟入路,而腹直肌旁入路的骨折复位优良率高于其他2种入路,且并发症更少。
