A meta-analysis of modified Stoppa approach and ilioinguinal approach in open reduction and internal fixation of Pelviacetabular fractures

Abstract

Background: The two common approaches to operate pelviacetabular fractures are Modified Stoppa Approach (MSA) and Ilioinguinal Approach (IA). The advantage of one approach over the other is debatable. Thus, this meta-analysis was undertaken to compare both the approaches and establish which approach is superior. Methods: A literature search was conducted using PubMed database for articles comparing MSA and IA for pelviacetabular fractures. Articles were included after thorough perusal by 2 trained authors in accordance with the Cochrane Handbook for potential risk. The articles were rated based on Jadad scale for quality assessment. The data extracted from the articles was evaluated and compared for operative time, intraoperative blood loss, reduction quality, clinical outcome, and complications. Results: Eventually only 5 articles fitting the inclusion criteria were included in the meta-analysis. Total patients in the MSA group were 186 and that in the IA group were 219. The advantage of MSA over IA was found in the significantly shorter operative time (p=0.0002), better reduction quality (p=0.03) and decreased intra operative blood loss (p=0.002). No difference was found in clinical outcome (p=0.63) and complication rates (p=0.34).Conclusion: Through this meta-analysis it was established that MSA does offer superior approach in treating pelviacetabular fractures in terms of operative time, reduction quality and intra operative blood loss but shows no difference when it comes to clinical outcome and complications.