| Objective To compare the clinical outcomes of unstable pelvic anterior ring fractures using the MIPPO approach versus the modified Stoppa approach.Methods The clinical data of 34 patients with pelvic anterior ring fractures who were treated surgically in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2016 to October 2019 was analyzed retrospectively, and they were classified into the MIPPO approach group (20 cases) and the modified Stoppa approach group (14 cases). The operation time, intraoperative blood loss, incision length, ASA score, intraoperative fluoroscopy frequencies, postoperative inflammatory indicators (D-D dimer, procalcitonin, hypersensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), white blood cell count, and neutrophile granulocyte count), length of postoperative hospital stay, ambulation time, bone union time, full loading time, and complications rate were compared between the two groups. Matta score and Majeed score were used to evaluate recovery condition of pelvic fractures postoperatively.Results The average followed-up time was (30.24±9.39) months (20-60 months) in two groups. The operation time, intraoperative blood loss, incision length and intraoperative fluoroscopy frequencies in the MIPPO approach group were lower than those in the modified Stoppa approach group (P<0.05). Postoperatively, the inflammatory indicators (D-D dimer, ESR and neutrophile granulocyte count), length of postoperative hospital stay, and ambulation time in the MIPPO approach group were lower or earlier than those in the modified Stoppa approach group (P<0.05). The ASA score, procalcitonin, hs-CRP, white blood cell count, bone union time, full loading time, Matta score grade, Majeed score and grade, and complications rate between two groups were not statistical difference (P>0.05). Reexamined anteroposterior X-ray of the pelvis within 7 days postoperatively, the excellent-good rate of Matta score in the MIPPO approach group and the modified Stoppa approach group were 95.00% and 85.71% separately. At last follow-up, the excellent-good rate of Majeed score in the MIPPO approach group and the modified Stoppa approach group were 90.00% and 78.57% separately.Conclusion The MIPPO approach to treat anterior pelvic ring can obtain satisfactory outcomes, and compared with the modified Stoppa approach, has some advantages of shorter operation time, lower blood loss, shorter incision length and postoperatively earlier ambulation time, etc. This method deserves promoting. |
