Stoppa入路在骨盆髋臼骨折中的初步应用

目的 探讨在骨盆髋臼骨折中采用耻骨联合上缘横形或下腹正中切口,真骨盆内操作(Stoppa人路)的初步临床经验. 方法对2008年3月至11月问应用Stoppa入路治疗的10例骨盆髋臼骨折患者进行总结.5例骨盆患者均为Tile C型,Stoppa入路复位同定前环的高位耻骨支骨折.髋臼骨折为横行2例,双柱、T型及后柱(四边体粉碎骨折伴中心脱位)骨折各1例,单纯Stoppa入路2例,联合Kocher-Langenbeck及髂腹股沟入路3例. 结果所有骨盆骨折均复位优,所有髋臼骨折均解剖复位.Stoppa入路平均切口长度10 cm(9～12 cm),平均手术时间88 min(75～105 min),半均出血560 mL(250～800 mL),无手术并发症.7例获得4～8个月随访,功能结果均满意. 结论 Stoppa入路可以替代髂腹股沟入路治疗高位耻骨支骨折,也可单独或联合其他入路治疗髋臼骨折,具有操作简单、并发症少的优点.

Stoppa approach in pelvic and acetabular fractures

Objective To report our preliminary clinical experience of using the Stoppa approach in treatment of pelvic and acetabular fractures. Methods From March 2008 to November 2008, 10 cases of pelvic and acetabular fracture were treated through the Stoppa approach - low abdomen midline or suprapuhic transverse incision and infra-peetineal plating. Of them, 5 pelvic cases were all Tile type C. The Stoppa ap-proach was used to manage each fracture of peripheral pubic ramus. The other 5 cases of acetabular fracture included 2 transverse, 1 posterior column, 1 T type and 1 both column ones. The Stoppa approach was used exclusively in 2 cases, and together with Kocher-Langenbeck or ilioinguinal approach in the other 3 cases. Results The average incision length of the Stoppa approach was 10 cm, the mean operation time and blood loss were 1.5 hours and 560ml respectively. The reduction of the pelvic and acetabular fractures were all excellent. There were no operative complications. Of them, 7 cases were followed up for 4 to 8 months, showing satisfactory functional results. Conclusion The Stoppa approach can replace the ilioinguinal approach in management of fractures of peripheral pubic ramus, and can be used together with other ap-proaches for acetahular fractures, but it has advantages of simple dissection and a low complication rate.