UNASSIGNED: A retrospective review aims to investigate the operative methods and therapeutic effects of the modified Stoppa approach for treating pelvic and acetabular fractures.
UNASSIGNED: 18 patients with acetabular fracture of the anterior column and pelvic anterior ring fracture underwent surgical treatment using the modified Stoppa approach. Some of the treatment was combined with the iliac fossa approach or rear K-L approach. Fracture reduction and postoperative function were evaluated using the Matta scoring standard and the Majeed scoring system. The Oxford Centre for Evidence-Based Medicine system was used to grade the literature review and create graded B recommendations.
UNASSIGNED: Incision length was 6-12 cm (mean, 10 cm), operative duration was 50-150 minutes (mean, 85 minutes), and intraoperative blood loss volume was 400-1,000 ml (mean, 500 ml). 18 patients were followed up for 12-36 months post-operation. In the results of X-ray films, 12 cases were anatomical reductions and the remaining cases were satisfactory reductions. According to Majeed standard, 13 patients were excellent and five patients were good.
UNASSIGNED: Treatment using the modified Stoppa approach was suitable for anterior approaches, in which pelvic and acetabular fractures were sufficiently exposed, the fracture was conveniently reduced, less complications occurred, and curative effect was satisfactory. Level of evidence III, Retrospective comparative study.
UNASSIGNED: Uma revisão retrospectiva tem como objetivo investigar os métodos operatórios e efeitos terapêuticos da abordagem modificada de Stoppa para o tratamento de fraturas pélvicas e acetabulares.
UNASSIGNED: 18 pacientes com fratura acetabular da coluna anterior e fratura do anel anterior pélvico foram submetidos a tratamento cirúrgico utilizando a abordagem de Stoppa modificada. Parte do tratamento foi feita em conjunto com a abordagem da fossa ilíaca ou com a abordagem pelo acesso posterior de K-L. A redução da fratura e a função pós-operatória foram avaliadas pelo padrão de pontuação de Matta e o sistema de pontuação de Majeed. O sistema do Oxford Centre for Evidence-Based Medicine foi usado para classificar a revisão de literatura e criar as recomendações de grau B.
UNASSIGNED: O comprimento da incisão foi de 6 a 12 cm (média de 10 cm), a duração da cirurgia foi de 50 a 150 minutos (média de 85 minutos) e o volume de perda sanguínea intraoperatória foi de 400 a 1.000 ml (média de 500 ml). 18 pacientes foram acompanhados por 12-36 meses após a operação. Nos resultados dos filmes radiográficos, 12 casos foram de reduções anatômicas e os demais casos foram de reduções satisfatórias. De acordo com o padrão de Majeed, 13 pacientes foram considerados excelentes e cinco pacientes foram considerados bons.
UNASSIGNED: O tratamento que utilizou a abordagem de Stoppa modificada foi adequado para abordagens anteriores, nas quais as fraturas pélvicas e acetabulares estavam suficientemente expostas, a fratura foi convenientemente reduzida, ocorreram menos complicações e o efeito curativo foi satisfatório. Nível de evidencia III, Estudo retrospectivo comparativo.

BACKGROUND: The psoas minor partially inserted to the superior pelvic brim. And the plate used to fix the acetabular fracture has always been positioned at the pelvic brim after reduction through the Stoppa approach. However, there are few studies depicting the clinical significance of the psoas minor. The purpose of this paper was to explore the relationship between the insertion of the psoas minor tendon at the pelvic brim (IPMTPB) and screw placement through the Stoppa approach.
METHODS: Fifteen cadavers were dissected for adequate exposure to IPMTPB in our study. However, not all specimens had a psoas minor. For the specimens with IPMTPB, the posterior and anterior edges were used as the first and second entry points, dividing the area from the sacroiliac joint to the pubic symphysis into three zones (d1, d2 and d3). The average proportion of each zone was obtained after measurement the three zones, to locate the two entry points for the specimens without a psoas minor. From the longitudinal Stoppa incision, the first wire was inserted horizontally, and the second wire was placed vertical to the bone surface. Fluoroscopy and computed tomography (CT) were conducted to examine the relationship between the wires and the acetabulum.
RESULTS: There was a psoas minor in sixteen hemipelvises (53.33%). After measurement and calculation, we determined that the average proportions of zones d1, d2, and d3 were 28.03%, 29.14%, and 42.83%, respectively. For all specimens, the wires were successfully inserted, and the trajectories of the wires were outside the hip joint cavity.
CONCLUSIONS: IPMTPB could be used as an anatomic landmark of safe zones for screw placement through the Stoppa approach. For cases without a psoas minor, the zones for extra-articular screw placement could be determined through the measurements in this paper.