Comparison of effects of lateral rectus abdominis approach and modified Stoppa approach internal fixation in treatment of acetabular fractures
Objective:To compare effects of lateral rectus abdominis approach and modified Stoppa approach internal fixation in treatment of acetabular fractures.Methods:The clinical data of 94 patients with acetabular fractures admitted to this hospital from March 2021 to February 2023 were retrospectively analyzed.According to the different surgical approaches,they were divided into observation group and control group,47 cases in each group.Both groups were treated with open reduction and locking plate internal fixation.The control group was treated with modified Stoppa approach,while the observation group was treated with lateral rectus abdominis approach.The reduction effect,the perioperative index levels,the postoperative hip joint function(modified Merle D'Aubigné-Postel score),the stress response indexes[procalcitonin(PCT),cortisol(Cor),interleukin-6(IL-6)]levels before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:Three months after the surgery,the excellent and good rate of reduction in the observation group was 91.49%(43/47),and that in the control group was 87.23%(41/47),there was no significant difference between the two groups(P＞0.05).There was no significant difference in the fracture exposure time between the two groups(P＞0.05).The intraoperative blood loss in the observation group was less than that in the control group;the operation time,the hospitalization time and the fracture healing time were shorter than those in the control group;and the differences were statistically significant(P＜0.05).Three months after the surgery,the modified Merle D'Aubigné-Postel scores of pain,walking function and range of motion in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).One day after the surgery,the levels of serum PCT,Cor and IL-6 in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The incidence of complications in the observation group was 4.26%(2/47),which was lower than 19.15%(9/47)in the control group,and the difference was statistically significant(P＜0.05).Conclusions:The modified Stoppa approach and the lateral rectus abdominis approach have the same reduction effects on the patients with acetabular fractures,but the lateral rectus abdominis approach can reduce the intraoperative blood loss,shorten the operation time,the hospitalization time and the fracture healing time,reduce the postoperative stress response,reduce the incidence of complications,and improve the hip function.
万方数据
维普
