Evaluation of the of Non-Repairable Short External Rotator Muscles in Patients Undergoing Surgery via the Kocher-Lange beck Approach

Introduction: The Kocher approach is the most commonly used technique for treating fractures in the posterior wall and column of the acetabulum. This approach requires cutting the short external rotator muscles. In many cases, it becomes impossible to repair these muscles due to inadequate tissue quality, as the pressure from the fractured bone fragments may damage them. This study aims to assess the limitations in internal and external hip rotation compared to the intact side and to evaluate changes in clinical symptoms using the Harris Hip Score (HHS). Methods: The study involved ۳۰ patients with acetabular fractures who underwent surgery at Taleghani Hospital between March ۲۰۲۱ and September ۲۰۲۲. Only the Kocher approach was utilized for the surgeries. The assessment tools included a goniometer to measure the internal and external rotation of the hip and the Harris Hip Score questionnaire. Patients were evaluated six months after their surgery. Results: All patients in the study were men, with an average age of ۳۶ ± ۲ years. The most common type of fracture observed was the posterior wall fracture, which accounted for ۶۰% of the cases. The results revealed no statistically significant difference in the external rotation between the operated and intact hip. However, there was a significant difference in the internal rotation of the operated hip compared to the intact hip. The average score on the HHS questionnaire was ۸۹.۵۶, indicating a satisfactory outcome. Conclusion: The degree of external rotation in the hip is not solely reliant on the short external rotator muscles; other muscles, such as the gluteus maximus, sartorius, and psoas, also influence it. However, damage to the external rotator muscles, if not repaired, can reduce hip internal rotation. The HHS was also recorded at ۸۹/۵۶, which falls within the acceptable range and did not indicate a statistically significant decrease.

کلیدواژه ها:

Hip fracture ، Trauma ، Piriformis Muscle ، Acetabulum ، Sciatic nerve