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Short-segment fixation through a limited ilioinguinal approach for treating anterior acetabular fractures: a historical-control study

Identifieur interne : 000B52 ( Pmc/Corpus ); précédent : 000B51; suivant : 000B53

Short-segment fixation through a limited ilioinguinal approach for treating anterior acetabular fractures: a historical-control study

Auteurs : Mohamed Abo-Elsoud ; Yasser A. Radwan ; Mohamed Gobba ; Fouad Sadek

Source :

RBID : PMC:4071488

Abstract

Purpose

We evaluated the potential advantages of short-segment fixation of certain anterior acetabular fracture patterns through a limited ilioinguinal approach.

Methods

Two patient groups were studied. The first group comprised 22 patients (20 men, two women; average age 36 years) treated using the short-segment fixation protocol through a limited ilioinguinal approach. We modified the use of short pelvic brim plates, spring plates and posterior-column screws as reduction and fixation tools (leaving the distal end of the fracture unfixed) to keep the dissection entirely lateral to the iliac vessels. The second (control) group comprised 31 patients with matched fracture patterns fixed through the standard ilioinguinal approach. All patients were followed up for a minimum of two years. The estimated amount of blood loss (primary outcome measure), operative time, postoperative radiographic assessment of reduction quality and functional score assessment (secondary outcome measures) were compared between groups.

Results

The short-segment-fixation group had significantly less blood loss (p < 0.0001) and shorter operative time (p = 0.002) compared with the control group. However, there were no significant differences in the quality of fracture reduction and functional scores between groups at the final follow-up. No major complications were encountered in either group.

Conclusion

Short-segment fixation through a limited ilioinguinal approach is a safe and effective alternative for treating certain patterns of anterior acetabular fractures. Decreased blood loss and shorter operative time with less soft tissue dissection are the main advantages of this approach.


Url:
DOI: 10.1007/s00264-014-2354-6
PubMed: 24797562
PubMed Central: 4071488

Links to Exploration step

PMC:4071488

Le document en format XML

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<title>Purpose</title>
<p>We evaluated the potential advantages of short-segment fixation of certain anterior acetabular fracture patterns through a limited ilioinguinal approach.</p>
</sec>
<sec>
<title>Methods</title>
<p>Two patient groups were studied. The first group comprised 22 patients (20 men, two women; average age 36 years) treated using the short-segment fixation protocol through a limited ilioinguinal approach. We modified the use of short pelvic brim plates, spring plates and posterior-column screws as reduction and fixation tools (leaving the distal end of the fracture unfixed) to keep the dissection entirely lateral to the iliac vessels. The second (control) group comprised 31 patients with matched fracture patterns fixed through the standard ilioinguinal approach. All patients were followed up for a minimum of two years. The estimated amount of blood loss (primary outcome measure), operative time, postoperative radiographic assessment of reduction quality and functional score assessment (secondary outcome measures) were compared between groups.</p>
</sec>
<sec>
<title>Results</title>
<p>The short-segment-fixation group had significantly less blood loss (
<italic>p</italic>
 < 0.0001) and shorter operative time (
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 = 0.002) compared with the control group. However, there were no significant differences in the quality of fracture reduction and functional scores between groups at the final follow-up. No major complications were encountered in either group.</p>
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<sec>
<title>Conclusion</title>
<p>Short-segment fixation through a limited ilioinguinal approach is a safe and effective alternative for treating certain patterns of anterior acetabular fractures. Decreased blood loss and shorter operative time with less soft tissue dissection are the main advantages of this approach.</p>
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<journal-title>International Orthopaedics</journal-title>
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<pub-date pub-type="ppub">
<month>7</month>
<year>2014</year>
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<volume>38</volume>
<issue>7</issue>
<fpage>1469</fpage>
<lpage>1475</lpage>
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<date date-type="received">
<day>6</day>
<month>3</month>
<year>2014</year>
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<month>4</month>
<year>2014</year>
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<permissions>
<copyright-statement>© Springer-Verlag Berlin Heidelberg 2014</copyright-statement>
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<abstract id="Abs1">
<sec>
<title>Purpose</title>
<p>We evaluated the potential advantages of short-segment fixation of certain anterior acetabular fracture patterns through a limited ilioinguinal approach.</p>
</sec>
<sec>
<title>Methods</title>
<p>Two patient groups were studied. The first group comprised 22 patients (20 men, two women; average age 36 years) treated using the short-segment fixation protocol through a limited ilioinguinal approach. We modified the use of short pelvic brim plates, spring plates and posterior-column screws as reduction and fixation tools (leaving the distal end of the fracture unfixed) to keep the dissection entirely lateral to the iliac vessels. The second (control) group comprised 31 patients with matched fracture patterns fixed through the standard ilioinguinal approach. All patients were followed up for a minimum of two years. The estimated amount of blood loss (primary outcome measure), operative time, postoperative radiographic assessment of reduction quality and functional score assessment (secondary outcome measures) were compared between groups.</p>
</sec>
<sec>
<title>Results</title>
<p>The short-segment-fixation group had significantly less blood loss (
<italic>p</italic>
 < 0.0001) and shorter operative time (
<italic>p</italic>
 = 0.002) compared with the control group. However, there were no significant differences in the quality of fracture reduction and functional scores between groups at the final follow-up. No major complications were encountered in either group.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>Short-segment fixation through a limited ilioinguinal approach is a safe and effective alternative for treating certain patterns of anterior acetabular fractures. Decreased blood loss and shorter operative time with less soft tissue dissection are the main advantages of this approach.</p>
</sec>
</abstract>
<kwd-group xml:lang="en">
<title>Keywords</title>
<kwd>Ilioinguinal</kwd>
<kwd>Acetabulum</kwd>
<kwd>Fractures</kwd>
<kwd>Short segment</kwd>
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