Mohammad Qoreishy, Abdoreza Sajedi, Morteza Gholipour, Mona Gorji, Arash Maleki
{"title":"Clinical results of acetabular fracture treatment with hybrid fixation by anterior and posterior approach : A minimally invasive technique.","authors":"Mohammad Qoreishy, Abdoreza Sajedi, Morteza Gholipour, Mona Gorji, Arash Maleki","doi":"10.1007/s00508-023-02277-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Open reduction and internal fixation have been described as the gold standard for the treatment of acetabular fractures, but the high complications of these surgeries have led surgeons to seek less invasive procedures. In recent years, minimally invasive treatment, such as fixation through the skin have been proposed. The aim was to assess acetabular fracture outcomes of combination of posterior approach (Kocher-Langenbeck [KL]) with anterior percutaneous screw fixation (APSF) with minimally invasive surgery (MIS).</p><p><strong>Methods: </strong>Between February 2017 and July 2019, 155 patients with acetabular fractures underwent fixation with the KL + APSF approach. For 1 year functional outcomes, radiographic findings, and postoperative complications were evaluated.</p><p><strong>Results: </strong>Of 155 patients with a mean age of 40.16 ± 10.32 years, 82 patients were male and 73 were female. The most common pattern of fracture was both columns (32.9%). The average blood loss was approximately 527 ml. The average operation time was 85 min. The mean length of surgical incision was 113.3 mm. Harris' hip score was excellent in 75.5% of cases. The mean VAS score was approximately 4 and 91.6% of patients returned to pre-trauma activity. In 74.8% of cases, the reduction was anatomical. Complications after surgery were very insignificant and included the following: 2 patients had foot drop within 5 months both patients recovered, 2 patients had femoral nerve palsy and 3 cases of deep vein thrombosis and 1 case of pulmonary thromboembolism were treated. There were four patients with surgical site infections, all of whom recovered and two of the seven patients with osteoarthritis underwent total hip arthroplasty.</p><p><strong>Conclusion: </strong>Combining posterior approach with minimally invasive anterior method in fixation and treatment of acetabular fractures is a safe and reliable method and showed significant functional results with minimal complications.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wiener Klinische Wochenschrift","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00508-023-02277-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/10 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Open reduction and internal fixation have been described as the gold standard for the treatment of acetabular fractures, but the high complications of these surgeries have led surgeons to seek less invasive procedures. In recent years, minimally invasive treatment, such as fixation through the skin have been proposed. The aim was to assess acetabular fracture outcomes of combination of posterior approach (Kocher-Langenbeck [KL]) with anterior percutaneous screw fixation (APSF) with minimally invasive surgery (MIS).
Methods: Between February 2017 and July 2019, 155 patients with acetabular fractures underwent fixation with the KL + APSF approach. For 1 year functional outcomes, radiographic findings, and postoperative complications were evaluated.
Results: Of 155 patients with a mean age of 40.16 ± 10.32 years, 82 patients were male and 73 were female. The most common pattern of fracture was both columns (32.9%). The average blood loss was approximately 527 ml. The average operation time was 85 min. The mean length of surgical incision was 113.3 mm. Harris' hip score was excellent in 75.5% of cases. The mean VAS score was approximately 4 and 91.6% of patients returned to pre-trauma activity. In 74.8% of cases, the reduction was anatomical. Complications after surgery were very insignificant and included the following: 2 patients had foot drop within 5 months both patients recovered, 2 patients had femoral nerve palsy and 3 cases of deep vein thrombosis and 1 case of pulmonary thromboembolism were treated. There were four patients with surgical site infections, all of whom recovered and two of the seven patients with osteoarthritis underwent total hip arthroplasty.
Conclusion: Combining posterior approach with minimally invasive anterior method in fixation and treatment of acetabular fractures is a safe and reliable method and showed significant functional results with minimal complications.
期刊介绍:
The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.