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| Effect of two anterior acetabular approaches with low notch reconstruction plate fixation for acetabular quadrangular fractures #br# |
| YE Fang1 LAN Yinan2 HUANG Shuming1 YE Jifei1 XIE Panpan1 XING Hailin1 WANG Chong1 |
1.Department of Orthopedic Trauma, Lishui Central Hospital, Zhejiang Province, Lishui 323000, China;
2.Reconstructive Hand Surgery, Lishui Central Hospital, Zhejiang Province, Lishui 323000, China |
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Abstract Objective To investigate the effect of low profile reconstruction plate placement in the treatment of acetabular tetragonal fractures through the parabrectus approach or the ilioinguinal approach. Methods A total of 94 patients with acetabular tetragonal fracture from January 2016 to April 2021 in Lishui Central Hospital of Zhejiang Province were enrolled and they were divided into two groups by random number table method. The control group (47 cases) was treated with low profile reconstruction plate internal fixation via ilioinguinal approach, and the observation group (47 cases) was treated with low-notch reconstruction plate internal fixation via parabrectus approach. The operative time, intraoperative blood loss, incision length, fracture healing time, acetabular reduction effect, hip joint function, pain degree and complications were compared between the two groups. Results The operation time and incision length of the observation group were shorter than those of the control group (P ＜ 0.05), and the amount of intraoperative blood loss was less than that of the control group (P ＜ 0.05). In the observation group, the excellent and good rate was higher than that of the control group (P ＜ 0.05). Overall analysis showed that there were statistically significant differences in Harris score, modified Merle D’Aubigne-Postel score and VAS score between groups, time point comparison and interaction between the two groups (P ＜ 0.05). Intragroup comparison: Harris score and modified Merle D’Aubigne-Postel score at 6 and 12 weeks after surgery were higher than those before surgery, and 12 weeks after surgery were higher than those at 6 weeks after surgery. VAS score 6 and 12 weeks after surgery was lower than that before surgery, and 12 weeks after surgery was lower than that 6 weeks after surgery (P < 0.05). Comparison between groups: Harris score and modified Merle D’Aubigne-Postel score of observation group were higher than those of control group at 6 and 12 weeks after surgery (P ＜ 0.05), VAS score was lower than that of control group (P ＜ 0.05). The total incidence of complications in the observation group was lower than that in the control group (P ＜ 0.05). Conclusion The low profile reconstruction plate approach through the parastrectus abdominis has the advantages of less trauma, simple operation and high safety, and is more conducive to the reduction of the tetrahedral fracture block and the recovery of hip joint function, which is better than the ilioinguinal approach.
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