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Review
. 2021 Jun 15;35(6):661-666.
doi: 10.7507/1002-1892.202012113.

[Research progress of different surgical approaches in treatment of acetabular both-column fractures]

[Article in Chinese]
Xiao Liu  1   2 , Ming Li  1   2 , Jianheng Liu  1   2 , Zhongyang Liu  1   2 , Licheng Zhang  1   2 , Peifu Tang  1   2
Affiliations
Review

[Research progress of different surgical approaches in treatment of acetabular both-column fractures]

[Article in Chinese]
Xiao Liu et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To review the research progress of different surgical approaches in the treatment of acetabular both-column fractures.

Methods: The domestic and foreign related research literature on surgical approaches for acetabular both-column fractures was extensively consulted. The anatomical characteristics, exposure ranges, advantages, disadvantages, and indications of various common surgical approaches for both-column fractures were mainly summarized.

Results: The ilioinguinal approach is more suitable for both-column fractures if the anterior column fracture is complicated or combined with the anterior wall fracture while the posterior column fracture is simple and stable. The modified Stoppa approach or the lateral (para) rectus abdominal approach is the preferred choice when both-column fractures are combined with a quadrilateral fracture or femoral head dislocation. What's more, the Kocher-Langenbeck approach is required when the posterior column fractures are complicated or combined with posterior wall fractures. In addition, the simultaneous ilioinguinal and Kocher-Langenbeck approaches are the first choices when the both-column fractures possessing extremely severe and obvious displacement.

Conclusion: The reasonable choice of surgical approach is extremely important for acetabular both-column fractures. Each surgical approach has its advantages and limitations. It is necessary to take the precise reposition of the acetabular joint surface as the principle, and comprehensively judge the fracture types and severity of anterior column, posterior column, and square area, and then select the optimal surgical approach for surgical treatment.

目的: 对不同手术入路治疗髋臼双柱骨折的研究进展进行综述。.

方法: 广泛查阅国内外关于髋臼双柱骨折手术入路的相关研究文献，对常用手术入路的解剖特点、暴露范围、优缺点以及适应证等进行总结。.

结果: 髋臼双柱骨折中，若前柱骨折复杂或合并前壁骨折，而后柱骨折类型简单且稳定，首选髂腹股沟入路；若合并方形区骨折或伴有股骨头中央型脱位，而前后柱骨折相对简单且稳定，首选改良 Stoppa 入路或腹直肌外侧（旁）入路；若后柱骨折复杂或合并后壁骨折，前柱骨折相对简单且稳定，首选 Kocher-Langenbeck 入路；若双柱骨折严重，移位明显，首选髂腹股沟入路联合 Kocher-Langenbeck 入路。.

结论: 髋臼双柱骨折手术入路的合理选择至关重要，不同手术入路各有利弊，需要以髋臼关节面精准复位为原则，结合前柱、后柱和方形区骨折类型及严重程度进行综合判断，从而选择最优手术入路。.

Keywords: Acetabulum; both-column fractures; research progress; surgical approach.

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Conflict of interest statement

利益冲突：所有作者声明，在课题研究和文章撰写过程中不存在利益冲突。课题经费支持没有影响文章观点。

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