Assessment of Outcomes of the Modified Stoppa Approach in the Treatment of Acetabular Fractures: A Retrospective Cohort Study

<b>Aims.</b> To evaluate the efficacy of the modified Stoppa approach for surgical treatment of pelvic bone injuries based on clinical (sex distribution, fracture type), surgical (duration of operation, intraoperative blood loss, incision length, quality of reduction), and functional outcome (hip joint function). <b>Materials and methods.</b><b> </b>A total of 31 patient were included in a retrospective cohort study from 2019 until March 2022 with various injuries of acetabulum in the N.D. Batpenov National Scientific Center of Traumatology and Orthopaedics (NSCTO).The inclusion criteria for this study were: patients with acetabulum injuries, and who underwent surgical interventions using one of two surgical approaches (modified Stoppa, ilioinguinal approaches), patients over 18 years old. Exclusion criteria: other operative approaches to pelvic bones and patients under 18 years of age. 21 patients underwent surgery with the use of modified Stoppa approach (group A) and 10 surgeries were performed using the ilioinguinal approach (group B). Efficiency was evaluated by comparison of duration of surgical procedures, amount of blood lossbetween groups, size of skin incision, quality of reduction and functional outcomes.<b> Results.</b><b> </b>There are males – 18(58.1%), females – 13(41.9%) in the study. The clinical study results showed that average volume of intraoperative blood loss and size of skin incision were significantly less during Stoppa approach then ilioinguinal approach though average duration of surgical procedures did not reveal significant differences between two groups. Average duration of surgical procedures did not reveal significant differences between two groups – 109.5 min (±54.7) among group A and 126 min (±58.9) in group B. The volume of intraoperative blood loss averaged 338±254.5 ml of blood for the total sample. The volume of intraoperative blood loss was 525.0 ±322.5 ml of blood in group B, which is more than twice the estimated blood loss for group A (250 ±157.3 ml). When using a Stoppa approach, the length of the cutaneous surgical incision averaged at 8.8 ± 1.5 cm, while with an ilioinguinal approach, this value was estimated at 20.6 ± 8.5 cm, which suggests a favorable cosmetic effect of Stoppa approach. <b>Conclusion. </b>The positive results obtained with the modified Stoppa approach, which are reflected in a reduction in the length of the skin incision and the amount of intraoperative blood loss, suggest that the use of this approach in clinical practice provides an opportunity to improve the surgical treatment of acetabular fractures by obtaining variability in the study of surgical approach. Nevertheless, the frequency and complexity of the occurring pelvic bone injuries dictate the need for further search and improvement of more optimal access options for surgical treatment.