Modified Stoppa approach versus ilioinguinal approach in treatment of pelvic and acetabular fractures

LI Baofeng; ZHANG Ying; XIA Hong; YIN Qingshui; LI Mei; XIE Huibin; GUO Xiaoze; XIA Yuanjun; XIAO Jin; WANG Fei

doi:10.3969/j.issn.1674-666X.2015.06.004

Abstract：Objective To compare the differences of clinical efficacy between modified Stoppa and ilioinguinal approaches in the treatment of pelvic and acetabular fractures. Methods Clinical data of 98 patients with pelvic and acetabular fractures treated in Guangzhou General Hospital of Guangzhou Military Command from January 2010 to December 2014 with complete follow-up were retrospectively analyzed, in which 48 cases were treated by modified Stoppa approach, and other 50 cases treated by ilioinguinal approach. Clinical evaluation involved incision length, operative time, estimate blood loss volume, reduction of fractures, postoperative hip function scores, as well as postoperative complications. Results All patients were followed up for 6 months to 5 years (average, 12 months). The group of Stoppa approach was significantly superior to the ilioinguinal approach group in incision length [(9.2 ± 2.7) cm vs (15.1 ± 4.3) cm], operative time [(1.7 ± 0.7) h vs (2.0 ± 0.5) h] and estimate blood loss volume [(545 ± 230) mL vs (721 ± 156) mL], the difference between two groups had statistically significance (P <0.05). There were no statistically differences in reduction of fractures [the excellent and good rate of 94% (45/48) vs 92% (46/50), P >0.05] and hip function score [Matta standard, the excellent and good rate of 96% (46/48) vs 96% (48/50), P >0.05] at final follow-up. In modified Stoppa group, there were 2 cases of postoperative deep venous thrombosis; In ilioinguinal approach group, there were 1 case of superficial incision infection, 1 case of deep venous thrombosis, 3 cases of lateral femoral cutaneous nerve paralysis, and 1 case of inguinal hernia. The difference of complication rate between two groups had statistically significance (P <0.05). Conclusions Compared to ilioinguinal approach, the efficacy of procedure for pelvic and acetabular fractures by modified Stoppa approach is reliable, which has advantages of minimal invasiveness, short operation time, less blood loss, less complications, and sufficient exposure of quadrilateral surface, high superior ramus of pubis and bilateral pelvic and acetabular fractures.