The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures
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(2020) 15:588
RESEARCH ARTICLE
Open Access
The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures Yun Yang†, Chang Zou† and Yue Fang*
Abstract Background: At present, the choice of surgical approach for both-column fractures is still controversial. The purpose of this study was to explore the efficacy of the Stoppa combined with iliac fossa (S+IF) approach in the treatment of both-column fractures. Methods: In this retrospective case series, 76 patients were included in the study from 2014 to 2018. They were divided into two groups according to the surgical approaches. The differences of intraoperative blood loss, operative time, quality of reduction, clinical outcome, and perioperative complications were compared between the two groups. Results: All patients had undergone the IL approach or the S+IF approach. The average operative time was 156.2 min (110~210 min) in group I and 126.5 min (80~180 min) in group II (P < 0.001). The average blood loss in group I was 784.1 ml, while the average blood loss in group II was 625.3 ml (P = 0.007). According to Matta’s criteria, 28 cases obtained anatomic reduction and 12 cases got imperfect reduction in group I; 21 cases obtained anatomic reduction and 7 cases got imperfect reduction in group II (P > 0.05). The clinical outcome (excellent to good) was 66% in group I versus 69% in group II (P > 0.05). The complication rates were 18.2% in group I and 12.5% in group II (P > 0.05). Conclusions: As a minimally invasive surgical approach, the S+IF approach is a valuable alternative to the IL approach for the treatment of both-column acetabular fractures if these two anterior approaches can achieve fracture exposure, reduction, and fixation. Keywords: Acetabular fracture, Both columns, Stoppa approach, Iliac fossa approach, Ilioinguinal approach, Internal fixation
Background Both-column fractures account for about 20% of the total number of acetabular fractures, which are characterized by no articular fragment in connection with the axial skeleton and fracture lines involving multiple planes [1–3]. In the treatment of acetabular fractures, * Correspondence: [email protected] † Yun Yang and Chang Zou contributed equally to this work. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
anatomical reduction and rigid internal fixation are very critical to obtain a good outcome [3–6]. In order to achieve accurate reduction and minimize complications, it is necessary to choose the appropriate surgical approach. The choice of surgical approach for both-column fractures is still controversial. The IL approach is the standard anatomic approach for most both-column fractures [7] and enables direct visualization of the anterior column up to the symphysis pubis. The exposure of the
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any
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