Anterior approaches in acetabular fractures: a true learning curve analysis.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
M Caudron, V Gerset, C Tronc, J Tonetti, M Boudissa
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引用次数: 0

Abstract

Today, acetabular surgeons in training have to learn ilioinguinal and anterior intrapelvic approaches (AIP). The aim of this study was to describe the 5-years learning curve of a surgeon. Objective was to assess clinical and radiological results; and to assess factors which could influence this learning curve. Between November 2015 and May 2020, patients with an acetabular fracture operated by the surgeon during the 5-years learning curve with an anterior approach were included in this single-center retrospective study based on a prospective database. Epidemiological, operative, clinical, radiological and complications data's were collected. To assess learning-curve effect the series was divided into two groups: first 2.5-years and last 2-years. Subgroup analysis were performed according to the surgical approach, to the reduction quality and the prognostic factors. In total, 46 patients were included, 23 in period 1 and 23 in period 2. 16 patients (35%) had ilioinguinal approach and 30 patients (65%) had modified Stoppa-Cole approach. At mean follow-up of 24 months, 38 patients (83%) were reviewed. Anatomical reduction (< 1 mm) was achieved in 28 patients (60.9%) with a 9% rate of perioperative complications and 37% rate of post-operative complications. In conclusion, this study gives a realistic overview of the learning curve of anterior approaches in acetabular fractures surgery. Our results should encourage surgeons, while keeping in mind how much this surgery can be challenging, with high rate of complications and difficulty to obtain a systematic anatomical reduction.

髋臼骨折的前路治疗:真实学习曲线分析。
如今,正在接受培训的髋臼外科医生必须学习髂腹股沟入路和前骨盆内入路(AIP)。本研究旨在描述外科医生的 5 年学习曲线。目的是评估临床和放射学结果;并评估可能影响这一学习曲线的因素。这项基于前瞻性数据库的单中心回顾性研究纳入了2015年11月至2020年5月期间由外科医生在5年学习曲线期间通过前路手术治疗的髋臼骨折患者。研究收集了流行病学、手术、临床、放射学和并发症数据。为评估学习曲线效应,该系列研究分为两组:前 2.5 年组和后 2 年组。根据手术方法、缩减质量和预后因素进行分组分析。共纳入了 46 名患者,其中 23 名在第一阶段,23 名在第二阶段。16名患者(35%)采用髂腹股沟入路手术,30名患者(65%)采用改良Stoppa-Cole入路手术。在平均 24 个月的随访中,对 38 名患者(83%)进行了复查。28名患者(60.9%)实现了解剖学缩小(小于1毫米),围手术期并发症发生率为9%,术后并发症发生率为37%。总之,这项研究真实地反映了髋臼骨折前路手术的学习曲线。我们的研究结果应鼓励外科医生,同时牢记这种手术具有很大的挑战性,并发症发生率高,而且难以获得系统的解剖复位。
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来源期刊
Acta orthopaedica Belgica
Acta orthopaedica Belgica 医学-整形外科
CiteScore
0.70
自引率
0.00%
发文量
58
审稿时长
4-8 weeks
期刊介绍: Information not localized
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