A Comparative Study Of MIPPO Under The Guidance Of BO And Modified Stoppa

OBJECTIVE: To summarize the development of Biological osteosynthesis(BO)theory,as well as its outline,content and methods,to complete pelvic MIPPO surgery under the guidance of BO theory.To compare the clinical data of MIPPO surgery and modified Stoppa surgery,and provide clinical basis for the treatment of pelvic anterior ring fracture.METHODS: Summarize the literature reports on the BO theory in recent years,summarize and analyze the concepts and methods of BO,clarify the principles of BO,and provide a theoretical basis for subsequent research.Patients with anterior pelvic ring fractures from the hospital in central China from January 2018 to December 2019 were selected which according to the inclusion and exclusion criteria.The 53 patients enrolled were divided into two groups: the MIPPO surgery group(group A,n= 36)and modified Stoppa surgery group(group B,n=17).The clinical and imaging data such as preoperative basic data,operation time,intraoperative blood loss and complications were collected(imaging data include data before operation,postoperative 1 week,after 1 month,3 months postoperatively),and postoperative general recovery and postoperative functional recovery were investigated by questionnaire at 1 month and 6 months after operation,according to the rules of Lowa score.RESULTS: One case who was lost to follow-up due to the novel coronavirus pneumonia was a group A patient,and the results will not be discussed in the data.The operation time in groups A and B was 51.1 ± 13.9min and 93.5 ± 17.7min respectively,and the intraoperative blood loss was 91.6 ± 13.7m L and 194.1 ± 43.5m L respectively,both of which were unilateral pubic branch time(only bilateral pubic branch fractures are recorded)Unilateral operation time,the differences between the two groups of indicators were statistically significant(P <0.05).There was no significant difference in the excellent and good rates of Matta’s fracture reduction and limb function recovery between the A and B groups(P> 0.05).All male patients had no symptoms such as epididymal swelling,pain,or testicular inflammation.One patient in group B had delayed healing of the incision,and the other patients had primary incision healing without infection.Two patients in group A had anterolateral and lateral regions of the posterior thigh.Feeling decreased,and healed at 1 month and 3 months after treatment respectively.One patient in group A had poor hip joint activity one month after the operation,and the hip joint function could be restored after the guidance of functional rehabilitation exercise.All the 52 patients were observed with the influence data of 1,3 and 6 months after the operation,showing that the internal fixation was intact without looseness,no internal fixation fracture,no screw looseness,and the fracture healing was good.CONCLUSION: For patients with anterior pelvic ring fractures,compared with the modified Stoppa operation,the MIPPO operation is relatively safe,the operation is relatively simple,the intraoperative bleeding is less,the risk of postoperative infection is indirectly reduced,the recovery is faster,etc.,it is clinically recommended and popular operation.