الفهرس | Only 14 pages are availabe for public view |
Abstract Acetabular fractures are among the most complex injuries treated by orthopaedic surgeons. Various approaches are well described in the literature and include the Kocher– Langenbeck, iliofemoral, ilioinguinal, combined anterior and posterior approaches, extended iliofemoral, transtrochanteric, and triradiate approaches. Stoppa described his approach first in 1973 as a subperitoneal median approach for the treatment of groin hernias with the support of a Dacron tulle prosthesis. In 1994, Cole and Bolhofner described the Stoppa approach, directing the surgeon to stand at the opposite side of the involved hip joint during reduction and fixation of the acetabular fractures, allowing for direct visualization of the medial wall, dome, quadrilateral plate, and extending as far as the sacroiliac joint. However, there is a scarcity in the published literature regarding the outcomes of Stoppa approach. Thus, we conducted the present study in order to assess the outcomes of modified Stoppa approach in patients with anterior wall, column, or both column acetabular fractures. The present study was a clinical study that was conducted on a cohort of 10 patients with acetabular fractures who were treated operatively using modified Stoppa approach at Banha university hospital during the period from January to December 2019. In the present study, the mean age of the included patients was 43.6 ±9.3 years and the majority of them were males (70%). The most common mechanism of injury in the present study was traffic accident (80%), followed by fall from height (20%). In the present study, 70% of the patients had associated injuries the Summary 86 most common associated injury was spine fracture (50%). In the present study, we found that the mean CT gap was 1.685 ±0.27mm. Eighty percent of the patients had anatomical Matta class. In the present study, 80% of the patients had excellent score according to Modified Merle d’Aubigné and Postel Method. Overall, we can conclude that the advantage of Stoppa approach are: Relatively easy anatomical dissection in comparison to the ilioinguinal approach Offers the surgeon better visibility than the classic ilioinguinal approach of all anterior elements, especially the quadrilateral plate Direct control over the corona mortis Direct visualization and approach to the posterior column Enables fixation and medial buttressing of the quadrilateral plate with a reconstruction plate, placed directly and medially to the hip joint, this has not been previously described in the ilioinguinal approach Study’s Limitations: We acknowledge that the present study has a number of limitations. The sample size of our cohort was relatively small which may affect the generalizability of our findings. Moreover, long-term patient centered outcomes were not utilized in our study. |