The effect of the Stoppa or Ilioinguinal approach on functional and radiological outcomes in the treatment of acetabular fractures involving the quadrilateral surface

Öz

Aim: The purpose of this study is to evaluate the functional and radiological outcomes of patients admitted to our clinic for acetabular fracture accompanied by a quadrilateral surface fracture, who were surgically treated with modified Stoppa or ilioinguinal incisions. Material and Methods: Patients who underwent surgery for acetabular fractures involving the quadrilateral surface between 2014-2019 were retrospectively screened and divided into two groups based on their surgical approaches (Modified Stoppa (MS) and Ilioinguinal (II)). Demographic and surgical data were recorded from the hospital information system. Radiological evaluations during follow-up were assessed using Matta's reduction quality and radiological staging. Functional outcomes were evaluated with the Harris Hip Score and the Merle d'Aubigné and Postel clinical scoring system. Results: A total of 32 patients with at least 12 months of follow-up were included. 53.1% (n=17) of the patients underwent surgery with the MS incision, and 46.9% (n=15) with the II incision. The mean operation time, mean length of hospital stay, and mean blood transfusion in the MS group were found to be significantly lower. No significant difference was observed in terms of Harris Hip Scores. Furthermore, when Matta's reduction quality criteria and radiological staging system criteria were evaluated, there was no significant difference. Conclusion: While there was no significant radiological or functional difference between the surgical approaches, the mean operation time, mean length of hospital stay, and mean blood transfusion were found to be shorter/less in the MS group.

Anahtar Kelimeler

• Quadrilateral surface
• acetabulum
• modified stoppa
• Ilioinguinal

Kuadrilateral yüzeyi ilgilendiren asetabulum kırıklarının tedavisinde stoppa veya ilioinguinal yaklaşımın fonksiyonel ve radyolojik sonuçlara etkisi

Öz

Amaç: Bu çalışmanın amacı, kliniğimize kuadrilateral yüzey kırığının eşlik ettiği asetabulum kırığı nedeniyle yatırılan, modifiye Stoppa veya ilioinguinal insizyonlar ile cerrahi tedavi edilen hastaların fonksiyonel ve radyolojik sonuçlarının değerlendirilmesidir. Gereç ve Yöntemler: Kliniğimizde 2014-2019 yılları arasında kuadrilateral yüzeyi ilgilendiren asetabulum kırığı sebebiyle cerrahi yapılan hastalar retrospektif olarak tarandı. Hastalar insizyonlara göre Modifiye Stoppa (MS) ve İlioinguinal (İİ) olarak 2 çalışma grubuna ayrıldı. Hastaların demografik verileri, travma şekli, travmaya bağlı ek kırık varlığı, verilen kan, komplikasyonlar hasta epikrizlerinden ve hastane bilgi sisteminden kayıt edildi. Kırığın tipi, Görüntü Saklama ve İletişim Sistemlerindeki (PACS) radyografiler ve tomografiler taranarak sınıflandırıldı. Redüksiyon kalitesi ve takiplerdeki radyolojik değerlendirmeleri Matta’nın redüksiyon kalitesi ve Radyolojik Evreleme sistemine göre yapıldı. Fonksiyonel sonuçlar Harris kalça skoru ve Merle d'Aubigne ve Postel klinik skorlama sistemi ile değerlendirildi. Bulgular: Çalışmamıza en az 12 ay izlemi olan 18 yaş üstü 32 hasta dahil edildi. Hastaların %53,1 (n=17) MS insizyonu ile %46,9 (n=15) ise İİ insizyonla ameliyata alındı. MS grupta ortalama ameliyat süresi, ortalama hastanede kalış süresi ve ortalama kan replasmanın İİ gruba göre anlamlı bir şekilde daha az olduğu bulundu. Harris kalça skorları açısından anlamlı bir fark gözlenmedi. Yine Matta’nın redüksiyon kalitesi kriterleri ve radyolojik evreleme sistemi kriterleri değerlendirildiğinde gruplar arasında anlamlı fark yoktu. Sonuç: Cerrahi yaklaşımlar arasında radyolojik ve fonksiyonel olarak anlamlı fark bulunmamakla beraber, MS grupta ortalama ameliyat süresinin ve ortalama hastanede kalış süresinin daha kısa, ortalama kan replasmanın daha az olduğu bulundu.

Anahtar Kelimeler

• Kuadrilateral yüzey
• asetabulum
• modifiye stoppa
• İlioinguinal

Kaynakça

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