Functional and radiological results of patients who have open reduction and i̇nternal fixation with stoppa or ilioinguinal approach in the treatment of acetabulum fractures relating to the quadrilateral surface

Purpose: The aim of this study is to evaluate the functional and radiological results of patients hospitalized in our clinic due to acetabulum fracture accompanied by quadrilateral surface fracture and treated surgically with modified Stoppa or Ilioinguenal approaches. Material and method: In our study, patients who were admitted to our clinic for acetabular fracture involving the quadrilateral surface between the years of 2014-2019 and were treated surgically were retrospectively reviewed. According to surgical approach to the patients were divided into 2 study groups, Modifie Stoppa and Ilioinguinal. By observing and searching the patients epicrisis and using the hospital data system the demographic data of the patients, the type of trauma, the presence of additional fractures due to trauma, the time of operation after the trauma, the blood and blood products given, and the postoperative complications were recorded . According to the Judet and Letournel classification, the type of acetabulum fracture was classified by evaluating the radiographs in the Picture Archiving and Communication Systems (PACS). Post-operative reduction quality and radiological evaluations of the patients in follow-up were made according to Matta's reduction quality and Matta's Radiological Staging system. Functional results were evaluated with Harris hip score and Merle d'Aubigne and Postel clinical scoring system. Findings: Over 18 years thirty-two patients over who were followed for during the least 12 months were included in our study. 53.1% (n17) of the patients were operated with Modifie Stoppa approaches and 46.9% (n15) with ilioinguinal approaches. 21.9% (n7) of our patients were female and 78.1% (n25) were male. The average age was 41.76 years in the MS group and 46.20 years in the II group. The mean operation time was 199.71 minutes SD (Standard deviation) 23,283 in the MS group and 293 minutes SD 30,752 in the II group. (p <0,001). The time until the operation day in the MS group was found in 6.12 days SD 2,934. This period was observed 5.73 days SD 3,494 in II group. (p=0,602). The median hospital staying was 3.76 days SD 0,903 in the MS group and 6.73 days SD 0,884 in the II group. (p<0,001). The median blood replacement rate was 1.24 SD 0,347, in the MS group and 2.60 SD 0,986 in the II group. (p<0,001). Development of AVN was observed in 1 patient, and it seemed that the wound infections was developed in 3 patient in group II. We never met with the nerve damage or DVT in our patients. Harris hip function score was excellent in 29.4% of our patients, good in 47.1%, fair in 11.8%, poor in 11.8%, in the MS group ,but in the II group we met with excellent in 33.3% ,% 40.0 good, 13.3% moderate, 13.3% bad values. D'Aubigne / Postel clinical score was excellent in 29.4% of our patients in the MS group, 47.1% good, 17.6% moderate, 5.9% poor, 26.6% excellent in the II group , 53.3% of them were found to be good, 13.3% moderate, and 6.8% bad values. Matta's reduction quality criteria were anatomical in 64.7% of our patients in the MS group, moderate in 29.4%, poor in 5.9%, anatomical in 60.0% in the II group, and moderate in 26.7%. , 13.3% had bad values. Matta's radiological staging system criteria 47.1% of our patients in the MS group had very good, 23.5% good, 17.6% moderate, 11.8% bad values, 46% of our patients in the II group had very good values , 7 had very good, 26.7% good, 13.3% moderate, 13.3% bad results. Conclusion: Although there was no radiological and functional significant difference between surgical approaches, it was found that in the MS group in terms of median operative time and hospital staying period was much shorter, mean blood replacement was much less