改良Stoppa入路在髋臼及骨盆骨折手术治疗中的应用

目的探讨采用改良Stoppa入路手术治疗髋臼及骨盆骨折的可行性和疗效。方法对5例髋臼骨折及13例骨盆骨折采用改良Stoppa入路手术治疗，对Tile C型骨盆骨折和髋臼前柱骨折联合应用髂骨翼处辅助切口，术中使用重建钢板固定．C型臂X线机透视评估骨折复位质量和内固定在位情况。结果本组平均切口长度11（9～13）cm，平均手术时间145（95～245）min，平均术中出血量675（375～1350）ml。术后骨折复位质量根据Matta影像学评分标准评定：骨盆骨折优10例，良3例；髋臼骨折优3例，良2例。18例获得3～19个月随访，平均9个月。末次随访时疗效根据Matta功能评分标准评定：优13例，良5例。结论与髂腹股沟入路相比，改良Stoppa入路操作安全，手术视野清晰，可直视下对髋臼前柱和四边体复位和固定，术后并发症少。在显露髋臼和骨盆前环时，该入路在临床上值得推荐。

Modified Stoppa approach for treatment of pelvic and aeetabular fractures

Objective To investigate the feasibility and effects of modified Stoppa approach in treatment of pelvic and aeetabular fractures. Methods Thirteen cases of pelvic fractures and 5 cases of acetabular fractures were treated with the modified Stoppa approach. The fractures were Tile C pelvic fractures and anterior column acetabular fractures. In combination with the lateral window of the ilioinguinal approach, open reduction and internal frxation was performed with a reconstructive plate. The fluoroscopy evaluation of the reduction and fixation in the operation were performed. Results The incision length was 9 to 13 cm（averaged 11 era）, the operation time was 95 to 245 rain（averaged 145 min）, the blood loss was 375 to 1 350 ml （averaged 675 ml）. Eighteen patients were followed-up for 3 to 19 months （averaged 9 months）. According to the Matta criteria,excellent reduction was obtained in 13 patients, a good reduction was obtained in 5 patients. Conclusion The modified Stoppa approach affords an excellent #isualisation of the anterior column and quadrilateral plate ,and allows for an exact reduction and stable fixation of their fraetures, and has a complication rate that is comparable to the ilioinguinal approach. Vie recommend the use of this technique when anterior exposure of the aeetabulum and the pelvic is required.