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Outcomes of the Modified Stoppa Approach in Acetabular Fracture Management: Incidence of Nerve Injuries

عنوان مقاله: Outcomes of the Modified Stoppa Approach in Acetabular Fracture Management: Incidence of Nerve Injuries
شناسه ملی مقاله: JR_TABO-12-2_006
منتشر شده در در سال 1403
مشخصات نویسندگان مقاله:

Kamyar Khoshabi - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Alireza Manafi Rasi - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Reza Zandi - Department of Orthopedic Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Farzad Amoozadeh Omrani - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Reza Tavakoli Darestani - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mirbahador Athari - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sina Afzal - Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

خلاصه مقاله:
Objectives: Displaced acetabular fractures are complex injuries that necessitate precise surgical intervention. Obturator nerve injuries occur in approximately ۲% of cases. The modified Stoppa approach, offering enhanced exposure of the quadrilateral plate, has gained attraction as an alternative technique for anterior acetabular fractures. However, its proximity to the obturator nerve poses a risk of iatrogenic injury. This study aimed to investigate the incidence of nerve injuries and functional outcomes in patients undergoing the modified Stoppa approach for traumatic acetabular fractures.Methods: This retrospective study involved ۸۶ patients with anterior column fractures, whose data were prospectively collected. The fractures were treated using the modified Stoppa approach. Exclusion criteria were pathological fractures, alternative surgical approaches, prior nerve injuries, hip issues, refusal to participate, or inadequate follow-up. Data collection involved pre-operative imaging, thorough post-operative neurological assessments, and post-operative radiographic evaluation. Functional outcomes were assessed using the Harris Hip Score (HHS).Results: Most patients were male (n=۵۴) with a mean age of ۴۰±۱۷.۳ years. Post-operative infection occurred in six cases, with resolution in four through antibiotics and two necessitating device removal. Obturator nerve damage was detected in ۱۴ patients, comprising nine traumatic and five iatrogenic cases. During the follow-up, symptoms improved in all patients, except for the four patients with iatrogenic nerve damage.Conclusion: Traumatic nerve injuries generally heal naturally over time. In contrast, iatrogenic injuries have a less optimistic prognosis, potentially resulting in lasting neurological deficits. Level of evidence: III

کلمات کلیدی:
Acetabulum, Fracture fixation, Iatrogenic Disease, Nerve injury, Obturator nerve

صفحه اختصاصی مقاله و دریافت فایل کامل: https://civilica.com/doc/1901064/