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The preserving insertion point of the rectus abdominisPfannenstiel approach for the treatment of anterior pelvic ring fractures / 中华骨科杂志
Chinese Journal of Orthopaedics ; (12): 810-816, 2019.
Article in Chinese | WPRIM | ID: wpr-755222
ABSTRACT
Objective To compare the clinical efficacy of the preserving insertion point of the rectus abdominis?Pfannen?stiel approach with traditional Pfannenstiel approach in the treatment of pelvic anterior ring injuries. Methods A retrospective analysis was performed on 43 cases with pelvic anterior ring injuries treated from September 2008 to February 2016. Among them, 20 cases were treated with the preserving insertion point of the rectus abdominis?Pfannenstiel approach (modified approach group) including 14 males and 6 females, aged 18-58 years, with an average age of 36.9 years. According to Tile classification of pelvic fractures, there were 8 cases of B1 type, 4 cases of B2 type, 2 cases of B3 type, 4 cases of C1 type and 2 cases of C2 type. And 23 cases were treated with traditional Pfannenstiel approach (traditional approach group, 16 cases of males and 7 cases of females, aged 19-59 years, with an average age of 36.8 years). Tile classification of pelvic fractures 9 cases of B1, 4 cases of B2, 3 cases of B3, 4 cases of C1 and 3 cases of C2). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative reduc?tion, postoperative functional and complications were compared between the two groups. Results 43 patients were followed up for 12-40 months, with an average of 20.5 months. All fractures healed in 8-20 weeks, with an average time of 10 weeks. Duration of anterior

approach:

119.0±18.3 min in the modified approach group and 93.7±17.8 min in the traditional approach group (t=4.597, P<0.05). Intraoperative blood loss 206.0±38.2 ml in the modified approach group and 252.4±46.1 ml in the traditional ap? proach group (t=-3.560, P<0.05). Postoperative hospital stay 14.5±3.0 d in the modified approach group, and 20.0±4.4 d in the traditional approach group (t=-4.775, P<0.05). Postoperative reduction was evaluated according to the Matta reduction criteria, among which 15 cases were excellent and 5 cases were good in the modified approach group; 17 cases were excellent and 6 cases were good in the traditional approach group. According to the Majeed score, the postoperative function of pelvic fracture was excel?lent in 10 cases, good in 7 cases, and acceptable in 3 cases, with an excellent and good rate of 85.0% (17/20). There were 11 excel?lent cases, 8 good cases and 4 fair cases in the traditional approach group, with an excellent and good rate of 82.6% (19/23). There was no statistically significant difference between the two groups (χ2=0.04,P >0.05). Complications 2 cases of internal fixation loosening and 2 cases of coital pain occurred in the modified approach group after surgery, with a complication rate of 20.0% (4/20). Postoperatively, 1 case of superficial infection, 1 case of pulmonary infection, 1 case of internal fixation loosening, 1 case of screw broken and 4 cases of coital pain occurred in the traditional approach group, with a complication rate of 34.8% (8/23). Conclu?sion Both approaches can achieve satisfactory results in the treatment of anterior pelvic ring injury. The preserving insertion point of the rectus abdominis?Pfannenstiel approach for the treatment of anterior pelvic ring injuries has the advantages of less bleeding, faster recovery and shorter hospitalization time.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Orthopaedics Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Orthopaedics Year: 2019 Type: Article