Short-term outcomes of mere modified Stoppa approach or in addition to ilia fossa approach for acetabular fractures / 中华创伤骨科杂志

ABSTRACT

Objective:Toevaluate the short-term outcomes of mere modified Stoppa approach or in addition to ilia fossa approach for acetabular fractures.Methods:From January 2016 to October 2019, 36 patients with acetabular fracture were treated at Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital. They were 28 males and 8 females with an average age of 45.2 years (from 27 to 78 years). The left side was affected in 15 cases and the right side in 21. By the Judet-Letournel classification, there were 13 anterior column fractures, 3 anterior column and wall fractures, 12 both-column fractures, 6 anterior and posterior hemitransverse fractures, and 2 T-shaped fractures.The time from injury to surgery averaged 6 days(from 2 to 12 days).All the patients were treated by open reduction and plate-screw fixation through the mere modified Stoppa approach or in addition to the ilia fossa approach.The quality of postoperative fracture reduction was evaluated according to the Matta score.The pain scores of visual analogue scale (VAS) for the patients before operation and 18 months after operation were recorded and compared. The fracture healing time, Harris hip score at the last follow-up and complications in the patients were recorded.Results:The average operation time in this cohort was 213.2 min (from 110 to 340 min). By the Matta scores, anatomical reduction was achieved in 28 cases and satisfactory reduction in 8.The 36 patients were followed up for an average of 20 months (from 18 to 25 months). Their VAS pain scores at 18 months after operation were(0.7 ± 0.6) points, significantly lower than those before operation [(6.7 ± 1.3) points] ( P<0.05). Their fracture healing time averaged 3.2 months (from 1.5 to 6.0 months). Their Harris hip scores at the last follow-up averaged 90.6 points (from 80 to 95 points), yielding 26 excellent and 10 good cases.There were no serious complications like internal fixation failure or neurovascular injury during the follow-up period. Conclusions:In the treatment of acetabular fractures, simple modified Stoppa approach or in addition to ilia fossa approach may lead to fine short-term outcomes, because fractures involving both anterior and posterior columns can be handled safely and effectively at the same time.