A systemic review and meta-analysis of pararectus versus ilioinguinal approach for the management of acetabular fractures.
Acetabular fractures
Fracture acetabulum
Ilioinguinal approach
Pararectus approach
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
30 Aug 2023
30 Aug 2023
Historique:
received:
17
06
2023
accepted:
17
08
2023
medline:
30
8
2023
pubmed:
30
8
2023
entrez:
30
8
2023
Statut:
aheadofprint
Résumé
The complex anatomy of acetabular fracture needs a surgical approach that can achieve anatomical reduction with fewer complications for the fixation of these fractures. Current literature suggests that both Pararectus (PR) approach and Ilioinguinal (IL) approach can be used for the fixation of these fractures safely. However, superiority of the PR approach over the IL approach is not established. Hence, this meta-analysis aimed to compare the PR versus IL approach. A literature search was performed on five databases Medline/PubMed, Scopus Embase, Cinhal, and Cochrane Library, from the inception to January 14, 2023. A qualitative and quantitative analysis was done for the five eligible studies from the literature search. Individual study characteristics data and outcomes were extracted, and Software version 5.4.1 of Review Manager was used for statistical analysis. Five articles, one Randomized trial (RCT), and four retrospective articles were included and analyzed in this meta-analysis. PR approach has a shorter surgical time [mean difference (MD) -48.4 with 95% CI -74.49, -22.30; p = 0.0003], less intraoperative blood loss (MD -123.22 with 95% CI -212.28, -34.15; p = 0.007), and smaller surgical incision (MD -9.87 with 95% CI -15.21, -4.52; p = 0.0003) than the IL approach. However, the meta-analysis failed to show a difference between the two surgical approaches concerning the quality of reduction, overall complications, nerve injury, vascular injury, heterotopic ossification, deep vein thrombosis, and pulmonary embolism. The PR approach has a shorter surgical duration, less blood loss, and a smaller surgical incision than the IL approach. However, both surgical approaches have equivocal results regarding fracture reduction quality, complication rates, and functional outcomes for acetabular fracture fixation. Hence, for acetabular fractures fixation, PR approach can be considered a safe and feasible alternative to the IL approach.
Identifiants
pubmed: 37646876
doi: 10.1007/s00590-023-03700-0
pii: 10.1007/s00590-023-03700-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Zou R, Wu M, Guan J, Xiao Y, Chen X (2021) Clinical Results of Acetabular Fracture via the Pararectus versus Ilioinguinal Approach. Orthop Surg 13(4):1191–1195. https://doi.org/10.1111/os.12970
doi: 10.1111/os.12970
pubmed: 33945221
pmcid: 8274146
Märdian S, Schaser KD, Hinz P, Wittenberg S, Haas NP, Schwabe P (2015) Fixation of acetabular fractures via the ilioinguinal versus pararectus approach: a direct comparison. Bone Joint J 97(9):1271–1278. https://doi.org/10.1302/0301-620X.97B9.35403
doi: 10.1302/0301-620X.97B9.35403
pubmed: 26330596
Srivastava A, Rajnish RK, Kumar P, Haq RU, Dhammi IK (2023) Ilioinguinal versus modified Stoppa approach for open reduction and internal fixation of displaced acetabular fractures: a systematic review and meta-analysis of 717 patients across ten studies. Arch Orthop Trauma Surg 143(2):895–907. https://doi.org/10.1007/s00402-022-04369-6
doi: 10.1007/s00402-022-04369-6
pubmed: 35138428
Letournel E (1993) (1993): The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Relat Res 292:62–76
doi: 10.1097/00003086-199307000-00009
Letournel E (1994) Fractures of the acetabulum. A study of a series of 75 cases. 1961. Clin Orthop Relat Res 305:5–9
doi: 10.1097/00003086-199408000-00002
Matta JM (2006) Operative treatment of acetabular fractures through the ilioinguinal approach: a 10 year perspective. J Orthop Trauma 20(1 Suppl):S20–S29
doi: 10.1097/01.bot.0000202389.40246.c0
pubmed: 16385203
Masse A, Aprato A, Rollero L, Bersano A, Ganz R (2013) Surgical dislocation technique for the treatment of acetabular fractures. Clin Orthop Relat Res 471(12):4056–4064. https://doi.org/10.1007/s11999-013-3228-8
doi: 10.1007/s11999-013-3228-8
pubmed: 24002867
pmcid: 3825905
Ma K, Luan F, Wang X, Ao Y, Liang Y, Fang Y et al (2013) Randomized, controlled trial of the modified Stoppa versus the ilioinguinal approach for acetabular fractures. Orthopedics 36(10):e1307–e1315. https://doi.org/10.3928/01477447-20130920-25
doi: 10.3928/01477447-20130920-25
pubmed: 24093709
Keel MJ, Ecker TM, Cullmann JL, Bergmann M, Bonel HM, Büchler L et al (2012) The Pararectus approach for anterior intrapelvic management of acetabular fractures: an anatomical study and clinical evaluation. J Bone Joint Surg Br 94(3):405–411. https://doi.org/10.1302/0301-620X.94B3.27801
doi: 10.1302/0301-620X.94B3.27801
pubmed: 22371551
Bastian JD, Savic M, Cullmann JL, Zech WD, Djonov V, Keel MJ (2016) Surgical exposures and options for instrumentation in acetabular fracture fixation: pararectus approach versus the modified Stoppa. Injury 47(3):695–701. https://doi.org/10.1016/j.injury.2016.01.025
doi: 10.1016/j.injury.2016.01.025
pubmed: 26861799
Shigemura T, Yamamoto Y, Maruyama J, Kitamura T, Nakane R, Kawaguchi H et al (2022) Efficacy and safety of pararectus approach for the treatment of acetabular fractures: a systematic review and meta-analysis. Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2022.103498
doi: 10.1016/j.otsr.2022.103498
pubmed: 36460292
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 372:n71. https://doi.org/10.1136/bmj.n71
doi: 10.1136/bmj.n71
pubmed: 33782057
pmcid: 8005924
Rajnish RK, Srivastava A, Yadav SK, Elhence A, Rathor K, Gupta S (2023) Pararectus versus ilioinguinal approach for the management of acetabular fractures: a protocol for systemic review and meta-analysis. MedRxiv. https://doi.org/10.1101/2023.04.14.23288547
doi: 10.1101/2023.04.14.23288547
Review Manager (RevMan) [Computer program] (2020) Version 5.4, The Cochrane Collaboration
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) (2003): Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73(9):712–716. https://doi.org/10.1046/j.1445-2197.2003.02748.x
doi: 10.1046/j.1445-2197.2003.02748.x
pubmed: 12956787
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD et al (2011) The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 343:d5928. https://doi.org/10.1136/bmj.d5928
doi: 10.1136/bmj.d5928
pubmed: 22008217
pmcid: 3196245
Haddaway NR, Page MJ, Pritchard CC, McGuinness LA (2022) PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Syst Rev 18(2):e1230. https://doi.org/10.1002/cl2.1230
doi: 10.1002/cl2.1230
pubmed: 36911350
pmcid: 8958186
Cao Qiyong Wu, Honghua Sun Xu, Chunpeng Zhao, Zhu Shiwen Wu, Xinbao. (2021) Comparison of perioperative data between the pararectus and ilioinguinal approaches in the internal fixation of acetabular fractures: a prospective randomized control trial. Chin J Orthop Trauma. 23(6):513–518
Wenzel L, von Rüden C, Thannheimer A, Becker J, Brand A, Augat P et al (2020) The pararectus approach in acetabular surgery: radiological and clinical outcome. J Orthop Trauma 34(2):82–88. https://doi.org/10.1097/BOT.0000000000001636
doi: 10.1097/BOT.0000000000001636
pubmed: 31714471
Zhu Y, Sheng XL, Sha WP, Zhang XX, Wang J, Xw Zhu et al (2021) Comparison of the efficacy and biocompatibility of two anterior acetabular approaches with low-profile reconstruction plate fixation in the treatment of acetabular fractures involving quadrilateral area. Zhongguo Zuzhi Gongcheng Yanjiu 25(27):4348–4353. https://doi.org/10.12307/2021.195
doi: 10.12307/2021.195
Keel MJ, Ecker TM, Siebenrock KA, Bastian JD (2012) Rationales for the Bernese approaches in acetabular surgery. Eur J Trauma Emerg Surg 38(5):489–498. https://doi.org/10.1007/s00068-012-0229-3
doi: 10.1007/s00068-012-0229-3
pubmed: 23162669
pmcid: 3495274
Nikolopoulos FV, Tzoras NT (2019) The advantages of stoppa approach-ilioinguinal modification, for surgical treatment of the acetabulum fractures with the traditional plate and the new anatomical suprapectineal plate system. J Orthop CaseRep 10(1):78–81. https://doi.org/10.13107/jocr.2019.v10.i01.1646
doi: 10.13107/jocr.2019.v10.i01.1646
Keel MJ, Tomagra S, Bonel HM, Siebenrock KA, Bastian JD (2014) Clinical results of acetabular fracture management with the Pararectus approach. Injury 45(12):1900–1907. https://doi.org/10.1016/j.injury.2014.10.040
doi: 10.1016/j.injury.2014.10.040
pubmed: 25457342
Liu W, Yang H, Yu Z, Zhao Y, Hu J, Li B, Zhu Y (2022) Comparison of therapeutic outcomes of transabdominal pararectus approach and modified stoppa approach in treating pelvic and acetabular fractures. Indian J Orthop 56(5):829–836. https://doi.org/10.1007/s43465-021-00585-1
doi: 10.1007/s43465-021-00585-1
pubmed: 35542317
pmcid: 9043044
Bastian JD, Tannast M, Siebenrock KA, Keel MJ (2013) Mid-term results in relation to age and analysis of predictive factors after fixation of acetabular fractures using the modified Stoppa approach. Injury 44(12):1793–1798. https://doi.org/10.1016/j.injury.2013.08.009
doi: 10.1016/j.injury.2013.08.009
pubmed: 24008225
Khoury A, Weill Y, Mosheiff R (2012) The Stoppa approach for acetabular fracture. Oper Orthop Traumatol 24(4–5):439–448. https://doi.org/10.1007/s00064-011-0093-z
doi: 10.1007/s00064-011-0093-z
pubmed: 22971850