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Clinical Efficacy and Safety Analysis of the Combined Kocher-Langenbeck (K-L) Approach for Complex Acetabular Fractures via the Ilioinguinal Groin |
YANG Xiaozhong, DENG Zhangyun, HU Song |
West China Guang'an Hospital, Sichuan University, Sichuan Guang'an 638000, China |
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Abstract Objective: To evaluate the effect of combined ilioinguinal and Kocher-Langenbeck (K-L) approach in the treatment of complex acetabular fractures. Methods: The clinical data of 75 patients with complex acetabular fractures admitted to the hospital between January 2018 and June 2020 were collected , and the patients were divided into observation group (combined ilioinguinal and K-L approach, 38 cases) and control group (KL approach, 37 cases) according to the two different surgical approaches. The two groups of patients were followed up for 1 year, and Matta imaging was used to evaluate and observe the postoperative fracture reduction and evaluate the clinical efficacy. The occurrence of postoperative complications (heterotopic ossification, osteoarthritis, avascular necrosis of the femoral head, neurovascular injury) were compared between the two groups. Merle d’ Aubigne and Postel scoring system was used to evaluate the hip function, and Barthel index (BI) and the MOS item short from health survey (SF-36) were applied to assess the hip function and quality of life of patients. Results: ① In terms of clinical efficacy, the 94.74% clinical effective rate in observation group was higher than 75.68% in control group (P<0.05), and the efficacy grading in observation group was better than that in control group (P<0.05). ② The incidence rate of postoperative complications was 7.89% in observation group, which was significantly lower than 27.03% in control group (P<0.05). ③ In terms of hip function, the differences of the above-mentioned scores after treatment and before treatment in observation group were higher than those in control group (P<0.01). ④ From the aspects of ability of daily living and quality of life, the differences of scores of BI and SF-36 after treatment and before treatmentwere were higher in observation group compared to control group (P<0.01). Conclusion: Combined ilioinguinal and K-L approach has good clinical efficacy and safety and few postoperative complications in the treatment of complex acetabular fractures, and can improve the hip function and enhance the ability of daily living and quality of life.
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