| Objective:In this study,a single anterior incision approach was used to treat complex acetabular fractures.It is proved that a single anterior incision approach is effective in the treatment of complex acetabular fractures.Materials and Methods:A retrospective analysis of 21 cases of complex acetabular fractures treated by operation in our department.According to the choice of surgical approach,they were divided into two groups（observation group and control group）.All patients in the observation group were treated with a single anterior approach,including 8 males and2 females,totaling 10 patients.The average age was 52.30±5.44 years old.In the control group,11 patients,including 8 males and 3 females,were treated with combined anterior and posterior approaches.Age ranged from 28 to 67,with an average age of 50.36±3.46.Patients in both groups received complete preoperative X-ray and THREE-DIMENSIONAL CT,complete obturator obturator oblique position,iliac crest oblique position and pelvis orthotopic position during the operation,and routine postoperative review was performed.The amount of blood loss,operative duration and incision length were recorded.The postoperative fracture reduction was evaluated by Matta standard.The patients were followed up from 6 months to 12 months after surgery.Harris score was used to evaluate the postoperative functional recovery of the hip joint.Results:Ten patients with complex acetabular fractures were treated with a single anterior approach by our physicians,and 11 patients with complex acetabular fractures were treated with anterior and posterior incision combined with an approach by our physicians.This study conducted a retrospective analysis of all cases,with the objectives as follows: 1.It was verified that accurate implantation of the posteriorIXcolumn screw of the acetabulum could be achieved by a single anterior approach,and the same efficacy could be achieved by anterior and posterior incision combined with the approach.2.The advantages and efficacy of single anterior incision were verified by comparing with anterior and posterior incision combined approach.There were 8 males and 2 females in the observation group.There were 8 males and 3 females in the control group,totaling 11 subjects.The gender data of patients in the two groups did not conform to the normal distribution.Fisher’s test was adopted,and the P value was 0.605（P > 0.05）,indicating that the difference was not statistically significant,indicating that the sample size was comparable.The observation group was 22-71 years old,with an average age of 52.30±5.44.The control group was 28-67 years old,with an average age of 50.36±3.48.The age data of patients in the two groups were in line with normal distribution,and independent sample T test was adopted.The F value was 4.474,P value was 0.048,P< 0.05,and the variance was uneven,so the T value was 0.300,P value was 0.768,P >0.05.The difference was not statistically significant,suggesting that the sample size was comparable.The operative time of acetabular fracture in the observation group was 180-330 minutes,with an average of 271.60±13.56 minutes.The operation time of acetabular fracture in the control group was 259-580 minutes,with an average of 367.27±33.43 minutes.The independent sample T test was adopted.The F value was 4.302,the P value was 0.052,P > 0.05,and the variance was homogeneous.Therefore,the T value was-2.555,the P value was 0.019,and P < 0.05.The difference was statistically significant,suggesting that in terms of the current sample size,the observation group was significantly shorter than the control group.The intraoperative blood loss of the observation group was 400ml-900 ml,with an average of 592.00±61.62 m.The amount of intraoperative blood loss in the control group was 1100ml-3000 ml,with an average of 1895.45±165.48 ml.The data of the two groups were in line with normal distribution.Independent sample T test was used,F value was 6.740,P value was 0.018,P < 0.05,and the variance was uneven,so the T value was-7.382,P < 0.001.The difference was statistically significant,suggesting that the blood loss in the observation group was significantly lower than that in the control group in terms of the current sample size.The incision length of the observation group was 8.5cm-25 cm,and the average incision length was 20.30 ± 2.02 cm.The incision length of the control group was45cm-55 cm,and the average incision length was 48.18±1.016.The incision length data of the two groups of patients did not conform to the normal distribution.Fisher’s test was adopted,and U value was 110.00,Z value was 3.956,P < 0.001,indicating that the incision length of the observation group was significantly shorter than that of the control group in terms of the current sample size.Patients in the two groups were followed up for 6-12 months after surgery,and the Harris score was 64-95 in the observation group,with an average score of 79.60±3.27.The average Harris score of the control group was 74.45±2.25 from 65 to 85.The Harris score data of the two groups were in line with normal distribution.Independent sample T test was adopted,and F value was 1.496,P value was 0.236,P > 0.05,with homogeneity of variance.Therefore,T value was 1.316,P value was0.204,P > 0.05,showing no statistically significant difference.There was no significant difference in postoperative hip function between the observation group and the control group.According to Matta scoring criteria,the postoperative reduction effect of the observation group was excellent in 9 cases and good in 1 case,with a total excellent and good rate of 100%.In the control group,the postoperative reduction effect was excellent in 9 cases,good in 1 case and fair in 1 case,with a total excellent and good rate of 90.9%.Conclusion:A single anterior approach for complex acetabular fractures results in the same excellent long-term hip function as a combined anterior and posterior approach for complex acetabular fractures,but with a reduction of an incision of an average length of 25 cm and a faster operation with less intraoperative blood loss. |
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