Comparison Of The Efficacy Of Stoppa Combined With Iliac Fossa Approach And Ilioinguinal Approach In The Treatment Of Acetabular Fractures

Research background:With the development of economy,the incidence of various traffic accidents and falling injuries is increasing,which directly leads to the increasing incidence of acetabular fractures year by year.Because of the deep location of acetabular fractures,complicated anatomy,and difficult surgical exposure,it has been known as the crown of orthopedic surgery.At the same time,acetabular fracture is a difficult problem for orthopedic surgeons for a long time due to its difficulty in reduction and postoperative complications.The complication of acetabular fracture is due to the characteristics of the fracture itself and the choice of surgical approach.How to choose an appropriate approach,both can give consideration to the aesthetic,and can be very good exposure to the fracture end,while reducing the operation time,reduce the occurrence of complications,is a problem orthopedic surgeons need to consider.Purpose: This paper mainly discusses the efficacy comparison of the Stoppa approach combined with iliac fossa approach and ilioinguinal approach in the treatment of acetabular fractures,so as to provide reference and basis for the choice of surgical approach for acetabular fractures.Method:In this paper,a retrospective analysis of Qinghai university hospital from January 2014 to January 2019 collection age range for 18 ~ 60 cases of acetabulum fractures at the age of 46 cases with Stoppa joint iliac fossa approach(group A)22 cases,iliac inguinal approach(B group)24 cases,compared two groups of patients with preoperative bleeding amount of basic information of operation time and postoperative complications,and according to the acetabulum fracture reset Matta standard quality follow-up evaluation of patients with postoperative fracture according to Merled hip function evaluation.The aubigne-postel scoring system understands the hip joint function of the patient.Consequence:In this study,a total of 46 cases of acetabular fractures were collected.The patients were followed up for 12 to 60 months after surgery,with an average follow-up time of 36 months.The operation time of Stoppa combined with iliac fossa approach and ilioinguinal approach was(143.21±17.23)min in group A and(171.95±21.9)min in group B.Intraoperative blood loss was(481.63±95.85)ml in group A and(594.32±110.59)in group B.Postoperative drainage volume was(95.74±22.47)ml in group A and(114.19±22.29)ml in group B.The difference of intraoperative blood loss and postoperative drainage between the two groups was statistically significant(P<0.05).According to the X-ray reexamination after the surgery,10 cases of anatomical reduction in the standard vertebra A group of reduction of acetabular fracture according to the reduction of Matta,10 cases were satisfied with the reduction,and 2 cases were dissatisfied with the reduction.There were 7 cases of anatomical reduction in group B,7 cases of satisfactory reduction and 10 cases of unsatisfactory reduction,the difference was statistically significant(P<0.05).The final hip function score of the two groups was(16.5±1.48)in group A and(14.71±1.03)in group B,with statistically significant differences(P<0.05).There was no statistically significant difference between the two groups in early postoperative complications(3 cases in group A and 3 cases in group B),long-term complications(3 cases in group A and 4 cases in group B)and total complications(6 cases in group A and 7 cases in group B)(P>0.05).Conclusion: Stoppa combined iliac fossa approach is better than the ilioinguinal approach in terms of both the time of operation and the satisfaction degree of reduction of postoperative drainage flow fracture and the postoperative hip joint function.In addition,the Stoppa combined iliac fossa approach has a clear exposure to the quadrilateral body and a short learning curve,which should be promoted.