Comparison Of The Clinical Efficacy Of The Lateral Rectus Abdominis Approach And The Modified Stoppa Approach In The Treatment Of Acetabular Fractures

Objective:To compare the clinical efficacy of the lateral abdominis rectus approach versus the modified stoppa approach in the treatment of acetabular fractures.Methods:A retrospective analysis was performed on the clinical data of 34 patients with acetabular fracture treated by trauma orthopedic surgery in the Second Hospital of Shanxi Medical University from January 2019 to January 2022.The lateral abdominis rectus approach(LRA)was used to treat 18 patients(LRA group)and the modified Stoppa approach(MSA)treated 16 patients(MSA group).To compare differences in time to surgical exposure,time to operation,intraoperative bleeding,excellent rate of Matta assessment,and hip scores(modified Merle d’Aubigne and Postel scores)between the two anterior surgical approaches.Results:Thirty-four patients successfully completed surgery and completed follow-up for at least 12 months after surgery.The lateral surgical approach group of rectus abdominis muscle was better than the modified stoppa approach group in terms of operation time(71.39±9.85min、87.86±6.89min、P<0.05)and intraoperative blood loss(212.77±19.19ml、302.81±26ml、P<0.05),and the difference was statistically significant.There were no significant differences in time to surgical exposure(9.78±1.56min、9.94±1.34min、P>0.05),assessment of Matta for fracture reduction(Z=-0.105、P>0.05),modified Merle d’Aubigne and Postel scores M(P25-P75)at one month postoperative[13(13 14)、13(13 14)、P>0.05],three months postoperative[14(14 15)、14(14 15)、P>0.05],and last follow-up[15(15 16)、15(15 16)、P>0.05].Conclusion:For bilateral acetabular fractures,a modified stoppa approach is advantageous in dealing with bilateral acetabular fractures with a single surgical incision.For unilateral acetabular fractures,the lateral approach to the rectus abdominis muscle is closer to the perilateral area of the pelvic acetabulum,with shorter surgery time and significantly less intraoperative bleeding,especially for acetabular fractures involving high anterior column and iliac fractures,which is a better option.