Comparison of the posterior hemipelvectomy of the greater trochanter approach with the standard Kocher-Langen-beck approach in the treatment of posterior acetabulum wall fractures
10.12200/j.issn.1003-0034.20221109
- VernacularTitle:大转子后半截骨入路与标准Kocher-Langenbeck入路治疗髋臼后壁骨折的疗效比较
- Author:
Jin ZHANG
1
;
Jian-Jun SHEN
;
Xiang HAI
;
Chuan-Yuan LIU
;
Wen-Jie ZHOU
;
Zhi-Wei CHEN
Author Information
1. 甘肃省中医院创伤骨二科,甘肃 兰州 730050
- Keywords:
Posterior hemipelvectomy of the greater trochanter;
Kocher-Langenbeck approach;
Posterior acetabulum wall fractures;
Perimeter indicators;
Hip function
- From:
China Journal of Orthopaedics and Traumatology
2024;37(8):786-792
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy of the posterior hemipelvectomy of the greater trochanter approach with the standard Kocher-Langenbeck(K-L)approach in the treatment of posterior acetabulum wall fractures and to explore a more optimal approach for the treatment of posterior acetabulum wall fractures.Methods Total of 26 patients with posterior ac-etabulum wall fractures were retrospectively analysed and divided into two groups:the posterior hemipelvectomy of the greater trochanter group(test group)and the standard K-L approach group(control group).In the test group,there were 24 patients including 16 males and 8 females with an average age of(42.00±4.52)years old,the time of injury to surgery was(6.75±1.15)d.In the control group,there were 23 patients including 16 males and 7 females with an average age of(41.00±5.82)years old,the time of injury to surgery was(7.09±1.20)days.The total hospital stay,length of incision,operation time,intraoperative bleeding,postoperative drainage,discharge,fracture reduction quality(Matta criteria),hip abduction muscle strength,hip func-tion(Merle d'Aubigne-Postel score),postoperative complications and the incidence of ectopic ossification were compared.Results All cases were followed up for 6 months.There was no significant difference in incision length,intraoperative bleeding and postoperative drainage between two groups(P＞0.05).However,the operation time of the test group was shorter than that of the control group(P＜0.05).There was no statistically significant difference in fracture reduction and hip function between two groups(P＞0.05).The hip abduction muscle strength of test group was better than that of control group(P＜0.05).In addition,there was no significant difference in the incidence of postoperative complications and heterotopic ossification between two groups(P＞0.05).Conclusion Compared with the standard K-L approach,the posterior hemipelvectomy of the greater trochanter approach can shorten the operative time,has better recovery of the postoperative hip abduction muscle strength,ex-poses the view of the fracture involving the more comminuted posterior acetabulum wall or the fracture of the roof of the socket,improved the rate of fracture anatomical repositioning,provides a new idea for the clinical treatment of posterior acetabulum wall fractures,and allows patients to perform functional exercises at an early stage.
