Modified Stoppa Approach And Rectus Lateral Approach Cure Acetabulum Fracture Curative Effect Comparision

Objective:Study the clinical utility of the modified stoppa approach and rectus lateral approach cure acetabulum fracture。Methods:Retrospective comparison method is used in our hospital in 2013-09 to2015-09,53 cases acetabulum fracture patients were analyzed, and all patients were divided into two groups, A and B.Patients of group A was treated with modified stoppa approach,B group of patients is to adopt the rectus side into the road treatment,To compare the curative effect of two groups,Clinical evaluation including operation time,intraoperative blood loss,intraoperative complications,thefracture degree of satisfaction,postoperative hip joint function.Modified stoppa approach:line of pubic sumphysis to the umbilical cords of lower abdominal midline incision,about12 cm in length,cut the skin,subcutaneous,from the bottom to ventral white line longitudinal split,into the peritoneum,dont cut off the rectus and cone muscle check point on the pubic bone。The rectus, the iliopsoas, femoral nerve and iliac blood vessels structure outward open forward, iliac shame fascial incision, fracture position.Beside the rectus approach:after lumbar hemp supine position, notch up from in front of pubic symphysis and iliac spines on the attachment in a third, check on prior to the umbilicus and iliac spine attachment 1/3 both home and abroad.Cut in the skin,subcutaneous and lower abdominal muscle,ligation under the abdominal blood vessels,the femoral nerve and iliopsoas muscle pull outward side,with intestinal pressure plate pull extraperitoneal pelvic viscera to the upper,pull the rectus inward,to expose the pelvis,(note the obturator and external iliac blood vessels anastomosis with Corona Mortis artery, and ligation), as subperiosteal dissection and exposure of fracture end, can reveal the ischiatic macroporous backward, forward can be revealed to the pubic symphysis. With quadrilateral body fractures, subperiosteal dissectionshow square body, pay attention to ligation obturator vessels, protect the obturator nerve.Results:Surgical exposure time in group A,B were(55.3±3. 2) min,(49.5 ± 3.6) min respectively,the last follow-up of hip joint function score(15.9 + /- 2.6),(16.3-2.3),the difference of two variables have no statistical significance(P > 0. 05), the fracture quality comparison, P > 0. 05, the difference has no statistical significance, but A, B two groups of intraoperative blood loss, in order(735-39), mL(677-31), there is statistical significance difference(P < 0.05), the comparison of two groups of patients with postoperative complications, P < 0.05, there was statistically significant difference.Beside the abdominal rectus muscle in the group and modified stoppa approach surgery quality of available and reset, hip function contrast, P > 0. 05, the difference is meaningless, but the comparison of intraoperative blood loss and postoperative complications, P < 0.05, differences are statistically significant.Conclusion:Rectus lateral approach to treatment in addition to the acetabulum after column, wall and wall of acetabulum fractures after rife with provides a new method of surgery, compared with classic iliac inguinal approach and modified stoppa approach has its own advantages, and can improve the acetabulum fracture reduction and fixation, with shorter operation time, intraoperative bleeding, less trauma, surgery vision clear, easy to reset and easy to operate, the characteristics of fewer complications and faster recovery.In surgical treatment of acetabulum fracture,the rectus lateral approach is an ideal choice.