The Post-Operative Outcome of Stoppa Approach in the Treatment of Anterior Column Acetabular Fractures
-
Mohamad Reza Sadeghi
,
Babak Siavashi
,
Seyyed Hossein Shafiei
,
Farhad Mahdavi
,
Mohammad Heshmati
,
Mohammad Reza Golbakhsh
Abstract
Background: Choosing the proper approach to surgical treatment of various types of acetabular fractures can play an important role in minimizing adverse outcomes during and after surgery. In the present study, we described our experience on the outcome of Stoppa approach in anterior column acetabular fractures.
Methods: This was a retrospective analysis of 40 patients with acetabular anterior column fractures that had undergone surgery with Stoppa approach. The study information, Harris Hip Score (HHS), and pre- and post-operative radiographic findings were collected by reviewing the hospital recorded files.
Results: HHSs of 80 to 100 were achieved in 75.0% of patients. Completed (anatomic reduction less than 2 mm) displacement reduction was found in 97.5%. 2 mg/dl decreased serum level of hemoglobin (Hb) was found in 75.0%, leading to blood transfusion in 60% of subjects. Regarding post-procedural complications, the common event was infection in 15.0%, followed by degenerative joint disease (DJD) in 15.0%. The post-operative complications were similar in men and women, but were significantly higher in patients older than 50 years than the younger patients.
Conclusion: Stoppa approach is associated with high success rate and the occurrence of rare and tolerable major complications.
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13. Andersen RC, O'Toole RV, Nascone JW, Sciadini MF, Frisch HM, Turen CW. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: Quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma. 2010;24(5):271-8. doi: 10.1097/BOT.0b013e3181b2b4ca. [PubMed: 20418731].
14. Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified rives-stoppa) approach for fixation of acetabular fractures. J Orthop Trauma. 2010;24(5):263-70. doi: 10.1097/BOT.0b013e3181dd0b84. [PubMed: 20418730].
15. Meena S, Sharma PK, Mittal S, Sharma J, Chowdhury B. Modified Stoppa Approach versus Ilioinguinal Approach for Anterior Acetabular Fractures; A Systematic Review and Meta-Analysis. Bull Emerg Trauma. 2017;5(1):6-12. [PubMed: 28246617]. [PubMed Central: PMC5316130].
16. Wang XJ, Lu L, Zhang ZH, Su YX, Guo XS, Wei XC, et al. Ilioinguinal approach versus Stoppa approach for open reduction and internal fixation in the treatment of displaced acetabular fractures: A systematic review and meta-analysis. Chin J Traumatol. 2017;20(4):229-34. doi: 10.1016/j.cjtee.2017.01.005. [PubMed: 28709737]. [PubMed Central: PMC5555276].
17. Caglar O, Kamaci S, Bekmez S, Tokgozoglu AM, Atilla B, Acaroglu E. Mid-term results of displaced acetabulum fractures surgically treated using anterior intra-pelvic approach (modified Stoppa). Ulus Travma Acil Cerrahi Derg. 2020;26(1):130-6. doi: 10.14744/tjtes.2019.03835. [PubMed: 31942727].
18. Yao Y, Xue C, Sun Y, Zhan J, Jing J. Comparison of effectiveness between two combined anterior and posterior approaches for complicated acetabular fractures. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018;32(12):1512-7. doi: 10.7507/1002-1892.201806096. [PubMed: 30569675].
19. Kilinc CY, Acan AE, Gultac E, Kilinc RM, Hapa O, Aydogan NH. Treatment results for acetabulum fractures using the modified Stoppa approach. Acta Orthop Traumatol Turc. 2019;53(1):6-14. doi: 10.1016/j.aott.2018.11.003. [PubMed: 30558866]. [PubMed Central: PMC6424668].
20. Elmadag M, Guzel Y, Aksoy Y, Arazi M. Surgical treatment of displaced acetabular fractures using a modified stoppa
approach. Orthopedics. 2016;39(2):e340-e345. doi: 10.3928/01477447-20160222-07. [PubMed: 26913763].
21. Liu Y, Yang H, Li X, Yang SH, Lin JH. Newly modified Stoppa approach for acetabular fractures. Int Orthop. 2013;37(7):1347-53. doi: 10.1007/s00264-013-1920-7. [PubMed: 23681609]. [PubMed Central: PMC3685676].
22. Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;(305):112-23. [PubMed: 8050220].
2. Okelberry AM. Fractures of the floor of the acetabulum. Journal of Bone and Joint Surgery-American. 1956;38(2):441-2.
3. Knight RA, Smith H. Central fractures of the acetabulum. J Bone Joint Surg Am. 1958;40-A(1):1-16. [PubMed: 13491604].
4. Rowe CR, Lowell JD. Prognosis of fractures of the acetabulum. J Bone Joint Surg Am. 1961;43(1):30-92. doi: 10.2106/00004623-196143010-00002
5. Matta J. Operative indications and choice of surgical approach for fractures of the acetabulum Joel. Tech Orthop. 1986;1(1):13-22. doi: 10.1097/00013611-198604000-00006
6. Letournel E, Judet R. Fractures of the acetabulum. Berlin, Germany: Springer Berlin Heidelberg; 1993.
7. Okelberry AM. Fractures of the floor of the acetabulum. J Bone and Joint Surg. 1956;38-A:441–2.
8. Judet R, Judet J, Letournel E. Fractures of the acetabulum: Classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-46.
9. Letournel E. The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Relat Res. 1993;(292):62-76. [PubMed: 8519138].
10. Letournel E. Fractures of the acetabulum. A study of a series of
75 cases. 1961. Clin Orthop Relat Res. 1994;(305):5-9. [PubMed: 8050246].
11. Hirvensalo E, Lindahl J, Kiljunen V. Modified and new approaches for pelvic and acetabular surgery. Injury. 2007;38(4):431-41. doi: 10.1016/j.injury.2007.01.020. [PubMed: 17445529].
12. Isaacson MJ, Taylor BC, French BG, Poka A. Treatment of acetabulum fractures through the modified Stoppa approach: Strategies and outcomes. Clin Orthop Relat Res. 2014;472(11):3345-52. doi: 10.1007/s11999-014-3460-x. [PubMed: 24420164]. [PubMed Central: PMC4182379].
13. Andersen RC, O'Toole RV, Nascone JW, Sciadini MF, Frisch HM, Turen CW. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: Quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma. 2010;24(5):271-8. doi: 10.1097/BOT.0b013e3181b2b4ca. [PubMed: 20418731].
14. Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified rives-stoppa) approach for fixation of acetabular fractures. J Orthop Trauma. 2010;24(5):263-70. doi: 10.1097/BOT.0b013e3181dd0b84. [PubMed: 20418730].
15. Meena S, Sharma PK, Mittal S, Sharma J, Chowdhury B. Modified Stoppa Approach versus Ilioinguinal Approach for Anterior Acetabular Fractures; A Systematic Review and Meta-Analysis. Bull Emerg Trauma. 2017;5(1):6-12. [PubMed: 28246617]. [PubMed Central: PMC5316130].
16. Wang XJ, Lu L, Zhang ZH, Su YX, Guo XS, Wei XC, et al. Ilioinguinal approach versus Stoppa approach for open reduction and internal fixation in the treatment of displaced acetabular fractures: A systematic review and meta-analysis. Chin J Traumatol. 2017;20(4):229-34. doi: 10.1016/j.cjtee.2017.01.005. [PubMed: 28709737]. [PubMed Central: PMC5555276].
17. Caglar O, Kamaci S, Bekmez S, Tokgozoglu AM, Atilla B, Acaroglu E. Mid-term results of displaced acetabulum fractures surgically treated using anterior intra-pelvic approach (modified Stoppa). Ulus Travma Acil Cerrahi Derg. 2020;26(1):130-6. doi: 10.14744/tjtes.2019.03835. [PubMed: 31942727].
18. Yao Y, Xue C, Sun Y, Zhan J, Jing J. Comparison of effectiveness between two combined anterior and posterior approaches for complicated acetabular fractures. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018;32(12):1512-7. doi: 10.7507/1002-1892.201806096. [PubMed: 30569675].
19. Kilinc CY, Acan AE, Gultac E, Kilinc RM, Hapa O, Aydogan NH. Treatment results for acetabulum fractures using the modified Stoppa approach. Acta Orthop Traumatol Turc. 2019;53(1):6-14. doi: 10.1016/j.aott.2018.11.003. [PubMed: 30558866]. [PubMed Central: PMC6424668].
20. Elmadag M, Guzel Y, Aksoy Y, Arazi M. Surgical treatment of displaced acetabular fractures using a modified stoppa
approach. Orthopedics. 2016;39(2):e340-e345. doi: 10.3928/01477447-20160222-07. [PubMed: 26913763].
21. Liu Y, Yang H, Li X, Yang SH, Lin JH. Newly modified Stoppa approach for acetabular fractures. Int Orthop. 2013;37(7):1347-53. doi: 10.1007/s00264-013-1920-7. [PubMed: 23681609]. [PubMed Central: PMC3685676].
22. Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;(305):112-23. [PubMed: 8050220].
| Files | ||
| Issue | Vol 5, No 4 (2019) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v5i4.4376 | |
| Keywords | ||
| Acetabulum; Fracture; Surgical Procedures | ||
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How to Cite
1.
Sadeghi MR, Siavashi B, Shafiei SH, Mahdavi F, Heshmati M, Golbakhsh MR. The Post-Operative Outcome of Stoppa Approach in the Treatment of Anterior Column Acetabular Fractures. J Orthop Spine Trauma. 2020;5(4):82-5.
