Clinical results of acetabular fracture treatment with hybrid fixation by anterior and posterior approach : A minimally invasive technique.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2023-10-10 DOI:10.1007/s00508-023-02277-2
Mohammad Qoreishy, Abdoreza Sajedi, Morteza Gholipour, Mona Gorji, Arash Maleki
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Abstract

Background: Open reduction and internal fixation have been described as the gold standard for the treatment of acetabular fractures, but the high complications of these surgeries have led surgeons to seek less invasive procedures. In recent years, minimally invasive treatment, such as fixation through the skin have been proposed. The aim was to assess acetabular fracture outcomes of combination of posterior approach (Kocher-Langenbeck [KL]) with anterior percutaneous screw fixation (APSF) with minimally invasive surgery (MIS).

Methods: Between February 2017 and July 2019, 155 patients with acetabular fractures underwent fixation with the KL + APSF approach. For 1 year functional outcomes, radiographic findings, and postoperative complications were evaluated.

Results: Of 155 patients with a mean age of 40.16 ± 10.32 years, 82 patients were male and 73 were female. The most common pattern of fracture was both columns (32.9%). The average blood loss was approximately 527 ml. The average operation time was 85 min. The mean length of surgical incision was 113.3 mm. Harris' hip score was excellent in 75.5% of cases. The mean VAS score was approximately 4 and 91.6% of patients returned to pre-trauma activity. In 74.8% of cases, the reduction was anatomical. Complications after surgery were very insignificant and included the following: 2 patients had foot drop within 5 months both patients recovered, 2 patients had femoral nerve palsy and 3 cases of deep vein thrombosis and 1 case of pulmonary thromboembolism were treated. There were four patients with surgical site infections, all of whom recovered and two of the seven patients with osteoarthritis underwent total hip arthroplasty.

Conclusion: Combining posterior approach with minimally invasive anterior method in fixation and treatment of acetabular fractures is a safe and reliable method and showed significant functional results with minimal complications.

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前后入路混合固定治疗髋臼骨折的临床结果:一种微创技术。
背景:切开复位和内固定术已被描述为治疗髋臼骨折的金标准,但这些手术的高并发症导致外科医生寻求微创手术。近年来,已经提出了微创治疗,例如通过皮肤固定。目的是评估后入路(Kocher-Langenbeck[KL])与前经皮螺钉内固定(APSF)结合微创手术(MIS)治疗髋臼骨折的疗效。方法:2017年2月至2019年7月,155名髋臼骨折患者接受了KL内固定 + APSF方法。对1年的功能结果、放射学检查结果和术后并发症进行评估。结果:155名患者平均年龄40.16岁 ± 10.32岁,男性82例,女性73例。最常见的骨折类型是两列(32.9%)。平均失血量约为527 ml。平均手术时间为85 最小手术切口的平均长度为113.3 Harris髋关节评分优良率为75.5%。平均VAS评分约为4,91.6%的患者恢复到创伤前活动。在74.8%的病例中,复位是解剖性的。术后并发症非常轻微,包括:2名患者在5个月内脚部下垂,两名患者都康复了,2名患者患有股神经麻痹,3例深静脉血栓形成和1例肺血栓栓塞得到了治疗。有四名手术部位感染的患者,他们都康复了,七名骨关节炎患者中有两名接受了全髋关节置换术。结论:后入路与微创前路联合固定治疗髋臼骨折是一种安全可靠的方法,并发症少,功能效果显著。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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