前方腹直肌外侧入路在儿童髋臼骨折治疗中的应用及临床疗效分析

doi:10.13418/j.issn.1001-165x.2023.6.17

Abstract

Abstract: Objective To analyze the feasibility, surgical method and clinical effect of lateral rectus approach (LRA) in the treatment of acetabular fractures in pediatric. Methods The clinical data and follow-up of 4 pediatric patients with acetabular fracture treated by lateral rectus incision in the Trauma Department of the Third Affiliated Hospital of Southern Medical University from January 2016 to December 2021 were retrospectively analyzed, including 3 females and 1 male, with an average age of 12.5 years (10~15 years old), 3 severe car accident injuries and 1 fall injury from height. Based on Judet-Letournel classification, There were 1 case of transverse fracture, 2 cases of double-column fracture, 1 case of anterior column combined with posterior hemi transverse fractures, 2 cases of sacroiliac joint dislocation, 1 case of sacral fracture and 3 cases of symphysis pubis dissociation. The indications and timing of operation were evaluated. Four cases were treated with lateral rectus approach. The reduction effect was evaluated according to Matta imaging reduction evaluation criteria, and the hip joint function was evaluated according to the modified Merle d'Aubigne-Postel score system. Results The 4 patients completed the operation successfully. No perioperative complications occurred. During the follow-up of 24~72 months, 4 cases were anatomically reduced according to Matta imaging reduction evaluation criteria, and 4 cases of fractures reached clinical and imaging healing standards within 2 months. Hip joint function was evaluated according to the modified Merle d'Aubigne-Postel score system: excellent in 4 cases. During the last follow-up, the morphology and structure of acetabulum in 4 cases were normal, the development was not significantly affected, and there was no abnormality in walking and daily life, and the fracture internal fixation was removed. Conclusions The incidence of acetabular fracture in children who need surgical treatment is very low, and the surgical method should be minimally invasive as far as possible. Four cases in this group were operated by lateral rectus abdominis incision, and a good short-term clinical effect was obtained.

Key words: Lateral-rectus approach; , , Pediatric; , , Acetabular fracture

CLC Number:

R683.3

Ye Shuxi, Yang Xiaodong, Li Tao, Mai Qiguang, Wang Hua, Fan Shicai . Application and clinical effect analysis of lateral anterior rectus approach in the treatment of acetabular fractures in pediatric[J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 728-732.

References 31

[1]	Liporace FA, Ong B, Mohaideen A, et al. Development and injury of the triradiate cartilage with its effects on acetabular development: review of the literature[J]. J Trauma, 2003, 54(6):1245-1249. DOI: 10.1097/01.TA.0000029212.19179.4A.
[2]	Clutter SY, Morgan SJ, Erickson M, et al. Management of an open acetabular fracture in a skeletally immature patient[J]. Open Orthop J, 2007, 1:9-12. DOI: 10.2174/1874325000701010009.
[3]	Passaplan C, Simonin A, Gautier E. Posterior wall acetabular fracture in a 13-year-old boy treated by open reduction and mini-plate internal fixation: long-term follow-up of 17 years[J]. Arch Orthop Trauma Surg, 2020, 140(9):1163-1167. DOI: 10.1007/s00402-019-03307-3.
[4]	Quick TJ, Eastwood DM. Pediatric fractures and dislocations of the hip and pelvis[J]. Clin Orthop Relat Res, 2005(432):87-96. DOI: 10.1097/01.blo.0000155372.65446.40.
[5]	Schlickewei W, Keck T. Pelvic and acetabular fractures in childhood[J]. Injury, 2005, 36 Suppl 1:A57-A63. DOI: 10.1016/j.injury.2004.12.014.
[6]	Bhandari Mohit，王簕，杨云峰. 骨盆或髋臼骨折儿童与成人患者死亡率的比较[J]. 中华创伤骨科杂志, 2013, 15(4):341-344. DOI: 10.3760/cma.j.issn.1671-7600.2013.04.014.
[7]	曹扬，汪志明，施铁军，等. 儿童开放性浮髋损伤两例[J]. 中华创伤杂志, 2008, 24(3):187-189. DOI: 10.3321/j.issn:1001-8050.2008.03.
[8]	郑强，潘志军，黄宗坚. 不稳定性儿童骨盆骨折的内固定治疗[J]. 中华小儿外科杂志, 2005, 26(2):93-96. DOI: 10.3760/cma.j.issn.0253-3006.2005.02.011.
[9]	王娟，吴新宝，李明，等. 儿童不稳定骨盆骨折治疗的回顾分析[J]. 中华骨科杂志, 2011, 31(11):1203-1208. DOI: 10.3760/cma.j.issn.0253-2352.2011.11.006.
[10]	陈伟，张奇，吕莉，等. 106例儿童骨盆骨折的回顾性分析[J]. 中华小儿外科杂志,2010,31(5):354-356.DOI: 10.3760/cma.j.issn.0253-3006.2010.05.010.
[11]	洪潮，顾小华. 儿童开放性骨盆骨折耻骨联合分离合并左股骨近端骨折一例报告[J]. 中华骨科杂志, 2002, 22(4):198. DOI: 10.3760/j.issn:0253-2352.2002.04.020.
[12]	Elmadag M, Acar MA. A modified stoppa (technique) approach for treatment of pediatric acetabular fractures[J]. Case Rep Orthop, 2013,478131. DOI: 10.1155/2013/478131.
[13]	de Ridder VA, Olson SA. Operative Treatment of Pediatric Pelvic and Acetabulum Fractures[J]. J Orthop Trauma, 2019, 33 Suppl 8:S33-S37. DOI: 10.1097/BOT.0000000000001644.
[14]	Guillaume JM, Pesenti S, Jouve JL, et al. Pelvic fractures in children (pelvic ring and acetabulum)[J]. Orthop Traumatol Surg Res, 2020,106(1S):S125-S133. DOI: 10.1016/j.otsr.2019.05.017.
[15]	Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury[J]. J Bone Joint Surg Am, 1996, 78(11):1632-1645. DOI: 10.2106/00004623-199611000-00002.
[16]	Heeg M, de Ridder VA, Tornetta PR, et al. Acetabular fractures in children and adolescents[J]. Clin Orthop Relat Res, 2000(376):80-86. DOI: 10.1097/00003086-200007000-00012.
[17]	Grisoni N, Connor S, Marsh E, et al. Pelvic fractures in a pediatric level I trauma center[J]. J Orthop Trauma, 2002, 16(7):458-463. DOI: 10.1097/00005131-200208000-00003.
[18]	Karunakar MA, Goulet JA, Mueller KL, et al. Operative treatment of unstable pediatric pelvis and acetabular fractures[J]. J Pediatr Orthop, 2005, 25(1):34-38. DOI: 10.1097/00004694-200501000-00009.
[19]	Hearty T, Swaroop VT, Gourineni P, et al. Standard radiographs and computed tomographic scan underestimating pediatric acetabular fracture after traumatic hip dislocation: report of 2 cases[J]. J Orthop Trauma, 2011, 25(7):e68-e73. DOI: 10.1097/BOT.0b013e3181f9a7ba.
[20]	Bucholz RW, Ezaki M, Ogden JA. Injury to the acetabular triradiate physeal cartilage[J]. J Bone Joint Surg Am, 1982, 64(4):600-609. DOI: 10.2106/00004623-198264040-00018.
[21]	Judet R, Judet J, Lanzetta A, et al. [Fractures of the acetabulum. Classification and guiding rules for open reduction][J]. Arch Ortop, 1968, 81(3):119-158. PMID: 5746773.
[22]	Igboechi O, Purtell SR, Carry P, et al. Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management[J]. J Pediatr Orthop, 2023, 43(7):424-430. DOI: 10.1097/BPO.0000000000002426.
[23]	Bryan WJ, Tullos HS. Pediatric pelvic fractures: review of 52 patients[J]. J Trauma,1979, 19(11):799-805. DOI: 10.1097/00005373-197911000-00001.
[24]	Heeg M, Klasen HJ, Visser JD. Acetabular fractures in children and adolescents[J]. J Bone Joint Surg Br, 1989, 71(3):418-421. DOI: 10.1302/0301-620X.71B3.2722933.
[25]	Schwarz N, Posch E, Mayr J, et al. Long-term results of unstable pelvic ring fractures in children[J]. Injury, 1998, 29(6):431-433. DOI: 10.1016/S0020-1383(98)00074-6.
[26]	Karunakar MA, Goulet JA, Mueller KL, et al. Operative treatment of unstable pediatric pelvis and acetabular fractures[J]. J Pediatr Orthop, 2005, 25(1):34-38. DOI：10.1097/00004694-200501000-00009.
[27]	刘涵，汪灿彬，陈家辉，等. 经腹直肌外侧入路髋臼翼形全万向锁定钢板固定治疗老年髋臼骨折[J]. 中华骨科杂志,2019,39(10):596-603. DOI: 10.3760/cma.j.issn.0253-2352.2019.10.002.
[28]	杨晓东，夏广，樊仕才，等. 单一腹直肌外侧切口治疗髋臼前后柱骨折[J]. 中华骨科杂志,2015,35(4):335-340. DOI：10.3760/cma.j.issn.0253-2352.2015.04.006.
[29]	李涛，汪灿彬，麦奇光，等. 腹直肌外侧入路结合术前3D打印技术治疗老年髋臼骨折[J]. 中华创伤骨科杂志, 2019, 21(6):516-523. DOI: 10.3760/cma.j.issn.1671-7600.2019.06.010.
[30]	杨晓东，刘涵，谷城，等. 髂坐钢板经腹直肌外侧入路治疗涉及方形区的髋臼骨折[J]. 中国矫形外科杂志, 2019, 27(20):1836-1840. DOI: 10.3977/j.issn.1005-8478.2019.20.03.
[31]	麦奇光，陈家辉，汪灿彬，等. 髋臼前后柱完整的股骨头中心性脱位一例报告[J]. 中华骨科杂志, 2019, 39(13):841-844. DOI: 10.3760/cma.j.issn.0253-2352.2019.13.009.

Application and clinical effect analysis of lateral anterior rectus approach in the treatment of acetabular fractures in pediatric

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References 31

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Jiang Jianhong, Duan Renpeng, Li Xiaofeng. Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 1-4.
[2]	Guo Hongzhi, Wang Yu, Zhang Jiaqi, Liang Haibin, Ma Ziwei, Feng Wei, Wu You, Si Ziyi. Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT three-dimensional model [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 5-10.
[3]	Li Jiawei, Zhang Jing, Li Canran, Lan Wenjie, Ji Qingyu, Guo Zhiyong, Zhang Yunfeng, Liu Qi, Chen Qingwei, Li Xiaohe. X-ray measurement of proximal femur anatomical parameters in Mongolian population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 11-16.
[4]	. Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 17-20.
[5]	Li Wen, Yang Siyi, Huang Lei, Qing Jiwen, Jiang Songtao, Zhang Lei. Morphological characteristics and clinical significance of Lisfranc ligament based on MRI [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 21-25.
[6]	Li Fanfan, Xu Yang, Wang Xiaoxu. Therapeutic effect of shikonin on the treatment of granuloma lobular mastitis in model rats by regulating Nrf2/HO-1 signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 26-32.
[7]	Wang Xinghang, Ding Jiayuan, Li Fang, Bao Cuifen, Yan Lijing. Ginsenoside Rg1 reduces the inflammatory response of microglia after oxygen glucose deprivation/resupply by inhibiting the NLRP3 inflammasome pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 33-41.
[8]	Cheng Yingying, Wu Jianjun, Cai Haiyan , Jiao Xunwen, Ma Jiangbo, Ding Yinxiu. Activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 42-46.
[9]	Qi Zhi, Yang Li, Jia Qiuye, Chen Haolun, Duan Zhaoda, Wu Chunyun. Edaravone regulates Sirt3 expression in lipopolysaccharide-activated microglia via MAPKs signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 47-53.
[10]	Zhang Jingjing, Wang Hongxin. Protective effect of Baicalin on rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 54-58.
[11]	Yue Qin, Chen Rongli, Xiong Jingxi, Wang Tingyi, Cai Zhiheng, Yi Qiushi, Zeng Xinyi. Effect of Bletilla striata polysaccharides on the choke-area of cross-boundary flap in rats [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 59-64.
[12]	Li Xiaoyu , Zhang Lei , Fu Lei , Li Dongbo , Wang Guoyou. Finite element study on the treatment of Sanders type II calcaneal fracture with three-step reduction method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 65-70.
[13]	Wu Yanfei, Ma Jianxiong, Lu Bin, Wang Ying, Bai Haohao, Jin Hongzhen, Ma Xinlong. Study on the correlation between the reconstruction of grayscale values using CT post-processing technology and the compressive strength of the endplate [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 71-76.
[14]	Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 77-82.
[15]	Luo Ying, Dou Weiyu, Wu Xiaohang, Chen Jingkun, Peng Changgui, Pan Jianying . Risk factors of postoperative complications of calcaneal fractures treated with hippocampal plate internal fixation through minimally invasive method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 83-88.