Operative treatment of complex acetabular fractures with ilioischial plating via modified Stoppa and iliac fossa approaches
10.3760/cma.j.issn.1671-7600.2017.08.003
- VernacularTitle:改良Stoppa入路联合髂窝入路髂坐钢板固定治疗复杂髋臼骨折
- Author:
Zhaoxiang WU
;
Yi OU
;
Ge CHEN
;
Zhong CHEN
;
Xin BI
;
Hang ZHAO
- Keywords:
Acetabulum;
Fractures;
bone;
Bone plates;
Fracture fixation;
internal;
Sur-gical approach
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(8):655-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effectiveness of ilioischial plating through modified Stoppa and iliac fossa approaches for complex acetabular fractures. Methods A consecutive series of 40 patients with complex acetabular fracture were treated operatively from January 2014 to February 2015. Of them, 20 were treated through modified Stoppa plus iliac fossa approaches as an experimental group ( including 12 males and 8 females with a mean age of 46. 8 ± 10. 3 years ) . The anterior column was stabilized with a recon-struction plate for the iliac wing along the iliopectineal line to the pubis in all cases. The posterior column was fixed with a newly developed ilioischial plate running from the ilium to the ischial ramus. The other 20 patients ( 10 males and 10 females with a mean age of 45. 6 ± 11. 7 years ) served as a control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach. The 2 groups were compared in terms of operative time, intraoperative blood loss, reduction and functional recovery of the hip. Results The 40 patients obtained an average follow-up of 18 months ( from 8 to 24 months ) . The experimental group reported significantly shorter operation time ( 2. 1 ± 0. 7 hours ) and signifi-cantly less intraoperative bleeding ( 320. 8 ± 100. 4 mL ) than the control group ( 2. 9 ± 0. 6 hours and 621. 6 ± 118. 7 mL, respectively ) ( P <0. 05 ) . According to modified Matta's criteria for reduction, the experimental group had 15 excellent, 3 good, one fair and one poor cases ( giving an excellent to good rate of 90％) while the control group had 17 excellent, one good, one fair and one poor cases ( giving an excellent to good rate of 90％) . According to the modified Merle d'Aubigné and Postel scoring for the functional recovery of the af-fected hip at the final follow-ups, the experimental group had 14 excellent, 3 good, 2 fair and one poor cases ( giving an excellent to good rate of 85％) while the control group had 12 excellent, 4 good, 3 fair and one poor cases (giving an excellent to good rate of 80％). There were no significant differences between the 2 groups in the above comparisons ( P> 0. 05 ) . There were no significant differences in the MOS item short form health survey score and postoperative complication rate between the experimental group and the control group. Conclu-sion Ilioischial plating through modified Stoppa and iliac fossa approaches has advantages of reliable fixa-tion, limited invasion, less intraoperative blood loss and fewer complications for complex acetabular fractures.
