The Anatomy And Clinical Research For Treating Acetabulum Fracture By Combine Iliac Groin Incision

Objective: To investigate the anatomic feasibility and clinical effect of treating acetabulum fracture by combine iliac groin incision.Methods: Select 10 Chinese adult cadaver specimens, 5 men and 5 women,contrast their left and right side, left side adopt the traditional iliac groin incision,the right adopt the combine iliac groin incision revealing from sacroiliac joint to the pubic symphysis. Taking 0 °and 30 ° of flexion of hip joint to measure the distance between the pubic and its front muscle lacuna and vascular cavity gap.From January 2001 to December 2014, our department treated 78 fracture of acetabulum patients, 36 cases(control group) of them are adopted the traditional iliac groin incision, 42 patients(experimental group) of them are adopted combine iliac groin incision, and to compare two groups of patients with operation time,blood loss, length of incision, complications and the fracture and dislocation of the hip function.Results: Both of two groups of incision reveal specimen from the sacroiliac joint to the pubic symphysis almost the entire half the pelvis. When hip flexion is30 °, due to that the tension decreases of ahead of the pubic bone muscle lacuna and vascular lacuna especially iliopsoas muscle, the incision of the two groupswas no significant difference; Compare operation time of two groups: the control group is 151.81±20.15 minutes, the experimental group is 131.55±18.59 minutes(P < 0.01); the blood loss value and hemoglobin decline value after operation of two groups, the control group is 571.39±79.43 ml and 12.25 ± 3.36g/L, the experimental group is 480.63±66.62 ml and 9.28 ±3.45g/L(P<0.01); The incision length of the control group is 21.70±1.69 cm, and the incision length of the experimental group is 16.57±1.12cm(P<0.01). The complications of the control group are more than the experimental group, but due to the complication rates are low in both groups, so no statistically significant. By Matta grading standard evaluation, two groups satisfaction rate for reduction of fracture were 97% and95%, respectively, by Merled’Aubigne and Poste grading standard evaluation, the hip joint function good rate of two group were 86% and 85.7%, the difference were no statistical significance(P > 0.05).Conclusions: Both traditional and combined groin incision surgery could obtain satisfactory fracture reduction and hip function, but the latter has the advantages of shorter operative time, shorter incision, less trauma, less blood loss and easy operation.