Comparison of the efficacy and biocompatibility of two anterior acetabular approaches with low-profile reconstruction plate fixation in the treatment of acetabular fractures involving quadrilateral area

doi:10.12307/2021.195

Abstract

Abstract: BACKGROUND: Conservative treatment for acetabular fractures involving quadrilateral areas was usually adopted, but with the in-depth research on the acetabular fractures and the development of orthopedic implants, surgical treatment is currently advocated. The anterior acetabular surgical approach includes the iliac-groin approach, the modified Stoppa approach, and the pararectus abdominis approach. It is of great clinical significance to select a more reasonable surgical approach.
OBJECTIVE: To compare the clinical efficacy and biocompatibility of the low-profile reconstruction plate through the pararetus approach and through the ilioinguinal approach for acetabular fractures involving quadrilateral areas.
METHODS: Clinical data of 41 patients with acetabular fracture involving quadrilateral area treated in Zhangjiagang Hospital Affiliated to Soochow University from January 2015 to October 2019 were retrospectively analyzed. All patients were assigned to pararetus approach group (n=21) and ilioinguinal approach group (n=20), and received low-profile reconstruction plate fixaiton. Relevant clinical indicators during perioperative period were recorded in the two groups. During follow-up, Matta imaging assessment criteria were used to evaluate the effect of fracture reduction. Modified Merle d’Aubigné-Postel criteria were used to assess the function of affected hips, and visual analogue scale was used to evaluate the pain degree of hip joint, and statistical analysis was conducted.
RESULTS AND CONCLUSION: (1) Totally 41 patients were followed up for more than 6 months. (2) The pararetus approach group was significantly better than the ilioinguinal approach group in incision length, fracture exposure time, operation time, blood loss and postoperative complications (P < 0.05). (3) Visual analogue scale scores were significantly lower in both groups at postoperative 6 months than that at postoperative 3 months (P < 0.05). The visual analogue scale scores in the pararetus approach group were significantly better than those in the ilioinguinal approach group during the follow-up of 3 and 6 months (P < 0.05). (4) The modified Merle d’Aubigné-Postel score was significantly higher in both groups at postoperative 6 months than that at postoperative 3 months (P < 0.05). The modified Merle d’Aubigné-Postel score was significantly higher in the pararetus approach group than that of the ilioinguinal approach group at the follow-up of 3 and 6 months (P < 0.05). (5) The difference of fracture healing time and satisfaction degree of fracture reduction had no statistical significance between two groups (P > 0.05). (6) Both anterior acetabular approaches with low-profile reconstruction plate can achieve good biocompatibility for acetabular fractures involving quadrilateral area. It is indicated that for acetabular fractures involving quadrilateral area, the placement of low-profile reconstruction plates through the pararectus approach has less trauma, higher safety, easier operation and better clinical efficacy.

Key words: acetabular fractures, quadrilateral area, fracture fixation, pararectus approach, plate, internal fixation

CLC Number:

Zhu Yin, Sheng Xiaolei, Sha Weiping, Zhang Xingxiang, Wang Jin, Zhu Xianwei, Wang Liming, Yan Fei. Comparison of the efficacy and biocompatibility of two anterior acetabular approaches with low-profile reconstruction plate fixation in the treatment of acetabular fractures involving quadrilateral area[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(27): 4348-4353.

Figures/Tables 9

References

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