Objective To evaluate the iliofemoral approach and its modified approaches in the treat-ment of acetabular fractures involving the roof column and roof wall.Methods A retrospective study was conducted to analyze the data of 19 patients who had been admitted to Department of Orthopaedics,The First Hospital Affiliated to Nanjing Medical University for acetabular fractures involving the roof column and roof wall from June 2015 to July 2023.There were 12 males and 7 females with an age of(53.5±15.6)years.By the three-column classification for the acetabular fractures,there were 2 cases of type A,7 cases of type B,and 10 cases of type C.The time from injury to surgery was 6(5,11)days.All patients underwent surgery through the iliofemoral approach or its modified approaches(the iliofemoral approach in 2 cases,the modified iliofemoral two-window approach in 13 cases,and the modified expanded iliofemoral two-window approach in 4 cases).All patients were fixated with plates and screws after reduction.The surgical time,intraoperative bleeding,complica-tions,quality of fracture reduction,and hip joint function of the affected side were analyzed.Results For all the 19 patients,the surgical time averaged(186.8±81.3)minutes,and the intraoperative bleeding volume 500(400,600)mL.After acetabular fracture surgery,anatomical reduction was achieved in 13 cases and satis-factory reduction in 6 cases.The follow-up period for the 19 patients was(42.6±25.9)months.All acetabu-lar fractures achieved bony union after a post-surgery duration of 14(12,16)weeks.By the modified Merle d'Aubigné & Poster scoring system,the hip function was evaluated at the last follow-up as excellent in 4 cases,as good in 14 cases,and as fair in 1 case.Follow-ups revealed injury to the lateral femoral cutaneous nerve after surgery in 11 patients,of whom 5 were fully recovered and 6 partially recovered after treatment.Ectopic ossification developed after surgery in 3 patients,of whom 1 was rated as Brooker grade Ⅰ and 2 were as Brooker grade Ⅱ.Conclusion In the treatment of acetabular fractures involving the roof column and roof wall,fixation with plates and screws through the iliofemoral approach or its modified approaches may achieve fine clinical outcomes in addition to the advantages of operative convenience and high safety.
关键词
髋臼/骨折/骨折固定术,内/手术入路/髂股入路
Key words
Acetabulum/Fractures,bone/Fracture fixation,internal/Surgical approach/Tips and tricks of iliofemoral approach
维普
万方数据