Comparison Of Modified Stoppa Approach And Inguinal Approach In The Treatment Of Acetabular Fractures

Objective: to compare the clinical effects of modified Stoppa incision approach and ilioinguinal approach in the treatment of acetabular fractures.Methods: 80 patients with acetabular fractures were selected from the department of orthopedics of our hospital from January 2011 to January 2015.All cases were treated with open reduction and internal fixation.According to the operative approach,40 cases were in the experimental group and 40 cases in the control group.The internal fixation of acetabular fractures was performed by modified Stoppa approach in the experimental group.The patients in the control group were treated with ilioinguinal approach for internal fixation of acetabular fractures.The clinical data of the patients were analyzed retrospectively,including age,gender,ASA grade,cause of injury and side injury.The incision length,operation time,intraoperative bleeding volume,postoperative hospitalization time,postoperative complications and the reduction quality of fracture 3 days after operation were compared between the two groups.The postoperative Matta imaging score and hip function score.The patients with acetabular fracture were closely followed up,so as to evaluate the effect of postoperative prognosis.Results:(1)The operative exposure time of the two groups was no significant difference(P > 0.05).(2)the length of incision and the amount of intraoperative bleeding in the experimental group were lower than those in the control group,and the difference was statistically significant(P < 0.05).(3)There was no significant difference in the excellent and good rate of Matta imaging score between the two groups on the 3rd day after operation.(P>0.05).(4)The incidence of postoperative complications was 10.00 % in the experimental group and 27.50% in the control group.The difference was statistically significant(P < 0.05).(5)Compared with pre operation,The score of hip joint function in the two groups has been improved(P < 0.05).There was no significant difference in scores between the two groups at discharge and at the last follow-up.(P >0.05).Conclusion: for complex acetabular fractures,the modified Stoppa approach and ilioinguinal approach are effective,but the modified Stoppa approach is simple to expose.The injury to peripheral superficial fascia,muscle and deep fascia is relatively small,so the amount of intraoperative bleeding is less and the incidence of complications is low,which accords with the concept of minimally invasive surgery in modern orthopedic surgery.