Purpose

This study aims to evaluate the efficacy of single pararectus approach in patients confirmed with acetabular fracture involving anterior and posterior columns.

Methods

A total of 58 patients confirmed with acetabular fracture involving anterior and posterior columns and treated at our hospital between January 2015 and January 2020 were retrospectively analyzed. A single pararectus approach was applied for all patients. Routine X-rays were performed at follow-up of one, three, six, 12, and 18 months, and three-dimensional CT scans were added at six and 18 months. Fracture reduction quality was assessed using the Matta score system, and functional assessment used the Modified Merle D’Aubigné and Postel score system. Post-operative complications, including fat liquefaction and deep vein thrombosis, were recorded and analyzed.

Results

The median operation time was 186 min while the intra-operative blood loss was 421 mL. The rate of good-to-excellent reduction was 94.8%, and the rate of good-to-excellent hip function score reached 93.1%. Seven patients presented with post-operative complications, including three intra-operative small vascular injuries, two peritoneal small perforations, one fat liquefaction, and one deep vein thrombosis.

Conclusion

Using a single pararectus approach is convenient and effective for treating acetabular fracture involving anterior and posterior columns, especially those involving the quadrilateral area.

Trial registration

ChiCTR, ChiCTR2100054604. Registered 21 December 2022. Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=144783.

中文翻译：

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单直肌旁入路治疗累及前后柱的髋臼骨折：手术经验及初步结果

目的

本研究旨在评估单直肌旁入路在确诊为累及前柱和后柱的髋臼骨折患者中的疗效。

方法

回顾性分析2015年1月至2020年1月期间在我院收治的58例确诊为累及前后柱的髋臼骨折患者。所有患者均采用单直肌旁入路。在随访 1、3、6、12 和 18 个月时进行常规 X 射线检查，并在 6 个月和 18 个月时增加三维 CT 扫描。骨折复位质量使用 Matta 评分系统进行评估，功能评估使用改良的 Merle D'Aubigné 和 Postel 评分系统。记录和分析术后并发症，包括脂肪液化和深静脉血栓形成。

结果

中位手术时间为 186 分钟，而术中失血量为 421 毫升。复位优良率94.8%，髋关节功能评分优良率93.1%。术后并发症7例，术中小血管损伤3例，腹膜小穿孔2例，脂肪液化1例，深静脉血栓形成1例。

结论

单直肌旁入路治疗累及前后柱的髋臼骨折，尤其是累及四边形的髋臼骨折，既方便又有效。

试用注册

ChiCTR，ChiCTR2100054604。2022 年 12 月 21 日注册。追溯注册，http://www.chictr.org.cn/showproj.aspx?proj=144783。