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| Clinical observation of modified Stoppa and ilioinguinal approach for the acetabular fractures |
| CHEN Dong1 ZHU Feng2 GONG Jie1 DI Dechun3 WANG Dechao4 |
1.Department of Orthopedics, Suzhou Xiangcheng People’s Hospital, Jiangsu Province, Suzhou 215000, China;
2.Department of Joint Surgery, the First Affiliated Hospital of Suzhou University, Jiangsu Province, Suzhou 215000, China;
3.Institute of Orthopedics, the First Affiliated Hospital of Suzhou University, Jiangsu Province, Suzhou 215000, China;
4.the Fifth Department of Orthopedics, the Second Affiliated Hospital of Luohe Medical College, He’nan Province, Luohe 462300, China |
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Abstract Objective To observe the clinical value of modified Stoppa and ilioinguinal approach in the treatment of acetabular fractures. Methods A total of 72 patients with acetabular fractures admitted to Suzhou Xiangcheng People’s Hospital, Jiangsu Province from May 2014 to September 2018 were selected as the study subjects, and they were divided into observation group and control group by random number table method, with 36 cases in each group. The control group was treated with ilioinguinal approach for fracture reduction, while the observation group was treated with modified Stoppa approach for fracture reduction. The operative time, intraoperative bleeding volume, incision length and hospitalization time were recorded. Matta imaging assessment criteria and Matta function score criteria were used to evaluate the reduction quality and hip function of the two groups at two months after operation, respectively. The levels of interleukin-6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT) in the serum of the two groups were measured one day before operation and one week after operation. The occurrence of lateral femoral cutaneous nerve injury, sciatic nerve injury, incision infection and traumatic arthritis were calculated. Results The operation time, intraoperative bleeding volume, incision length and hospitalization time in the observation group were lower than those in the control group, the differences were statistically significant (all P ＜ 0.05). There was no statistically significant difference between the two groups in satisfaction rate of reduction and excellent rate of hip joint function (P ＞ 0.05). The postoperative serum levels of IL-6, CRP and PCT in the two groups were all higher than those before surgery, and the differences were statistically significant (all P ＜ 0.05). The postoperative serum levels of IL-6, CRP and PCT in the observation group were all lower than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The modified Stoppa approach has the same efficacy as the ilioinguinal approach in the operation of hip fracture patients, but the former has more obvious advantages of minimally invasive, which can reduce the risk of inflammation in patients, reduce the incidence of adverse reactions, and provide better safety.
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[1] 黄屾.髋关节置换术与骨折内固定术治疗新鲜移位的老年股骨颈骨折的疗效对比[J].创伤外科杂志，2016，18（4）：223-225.
[2] Schwabe P，M?覿rdian S，Perka C，et al. Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach [J]. Oper Orthop Traumatol，2015，28（2）：91-103.
[3] 王春荣，岳立群，夏建华.改良Stoppa入路与髂腹股沟入路手术治疗骨盆和髋臼骨折的疗效比较[J].临床和实验医学杂志，2019，18（12）：1301-1304.
[4] 苏以林，闵敏，冯耀华，等.Stoppa入路在骨盆与髋臼骨折治疗中的应用研究进展[J].中华创伤骨科杂志，2015， 17（8）：687-691.
[5] 王满宜.骨盆与髋臼骨折国内治疗现状与将来发展趋势[J].中华创伤骨科杂志，2016，18（2）：93-94.
[6] 阎海威，胡居正，杨英，等.微创经皮骨盆前环内固定治疗不稳定性前环损伤的疗效及早期并发症分析[J].中华骨科杂志，2019，39（13）：826-832.
[7] 简争光，许运，史勇，等.锁定钢板固定修复侧方压缩旋转不稳骨盆环损伤：骨盆稳定性重建[J].中国组织工程研究，2015，19（48）：7776-7783.
[8] 仇道迪，周东生，许维澄，等.3D打印技术在陈旧性骨盆髋臼骨折治疗中的应用[J].中华创伤骨科杂志，2017，19（7）：624-629.
[9] 王钢.骨盆与髋臼骨折的治疗进展与评述[J].中华创伤骨科杂志，2019，21（3）：189-190.
[10] 余洋，陈龙，仇道迪，等. Kocher-Langenbeck入路联合部分近端Watson-Jones切口治疗涉及臼顶负重区的髋臼骨折[J].中华创伤骨科杂志，2018，20（3）：210-216.
[11] 黄复铭，温湘源，刘源城，等.直接后方入路治疗髋臼后部骨折[J].中华骨科杂志，2019，39（13）：789-795.
[12] 王虎，张堃，魏星，等.髂腹股沟入路短支撑钢板固定髋臼后柱治疗复杂髋臼骨折[J].中华骨科杂志，2017，37（1）：17-23.
[13] 苏达明，赵军华，胡伟.比较经腹直肌外侧入路与改良Stoppa入路治疗髋臼骨折的临床疗效[J].生物骨科材料与临床研究，2019，16（1）：38-41.
[14] 欧艺，吴照祥，陈仲，等.斜行髂坐钢板前路固定低位髋臼后柱骨折[J].中华创伤骨科杂志，2018，20（5）：382-388.
[15] 邓昶，倪卫东，郭书权，等.前后联合入路治疗陈旧性髋臼骨折的效果分析[J].中华外科杂志，2018，56（3）：196-200.
[16] 殷建新，李连欣.髂腹股沟与Stoppa入路手术治疗骨盆及髋臼骨折疗效对比观察[J].山东医药，2016，56（42）：57-58.
[17] 丘辉，李成鹏，吴剑挥，等.应用改良下腔静脉前入路法完整切除巨大腹膜后脂肪肉瘤10例临床分析[J].中国实用外科杂志，2016，36（6）：671-674.
[18] 王慧彪，王武超.单一髂腹股沟入路治疗复杂髋臼骨折[J].创伤外科杂志，2018，20（5）：363-366.
[19] 黄凯，查兴胜，沈点红.改良髂腹股沟入路手术治疗髋臼前柱或耻骨支骨折的疗效观察[J].中国骨与关节损伤杂志，2017，32（2）：176-177.
[20] 陈晓，马坤龙，徐海涛，等.改良Stoppa入路与髂腹股沟入路治疗骨盆、髋臼骨折的Meta分析[J].中国组织工程研究，2017，21（19）：3108-3116.
[21] 阿吉木·克热木，祖丽菲亚·买买提艾力，梁志林，等.计算机辅助数字化模型及3D打印导板技术在骨盆骨折诊断及治疗中的应用[J].疑难病杂志，2019，18（9）：923-927.
[22] 陈开放，段德胜，熊泽康，等.3D打印技术辅助高位髂腹股沟入路治疗复杂髋臼骨折[J].中华骨科杂志，2017， 37（13）：786-792.
[23] 吴华川，倪卫东.腹直肌旁入路治疗髋臼骨折的研究进展[J].中华创伤杂志，2018，34（3）：274-278.
[24] 罗兴良，吴坚，单贤贞.重建钢板经不同入路内固定治疗骨盆骨折的疗效[J].临床骨科杂志，2019，22（3）：288-291.
[25] 方浩伟，陈凯宁.Stoppa入路、经髂腹股沟入路对骨盆髋臼骨折患者术后运动功能及生活自理能力的影响观察[J].中国医药科学，2020，10（8）：263-266.
[26] 黄勇明，何武兵，许志贤，等.改良Stoppa入路与髂腹股沟入路手术治疗髋臼骨折疗效比较[J].中国骨与关节损伤杂志，2018，33（5）：86-88.
[27] 邹如意，吴敏，官建中，等.经腹直肌旁手术入路治疗髋臼骨折的研究进展[J].中国矫形外科杂志，2020，28（4）：332-335. |
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