The objective of this study was to determine whether the modified Stoppa approach or the ilioinguinal approach is better for the treatment of acetabular fractures by comparing the results of those 2 approaches. A randomized trial was undertaken of 60 consecutive patients with acetabular fractures treated with either the modified Stoppa or the ilioinguinal approach. In addition to the patients' demographics, the assessed preoperative parameters included fracture pattern, associated injuries, time to surgery, and Injury Severity Score; intraoperative parameters included blood loss and operative time for each procedure; and postoperative parameters included wound drainage, blood transfusion, perioperative complications, early operative complications, late operative complications, quality of reduction, radiological results, and clinical outcomes. The study showed no significant differences in all measured preoperative variables between the 2 groups (all P>.05). In addition, no significant differences were found in the intraoperative complication rate, early operative complication rate, late operative complication rate, quality of reduction, radiological results, and clinical outcomes (all P>.05). However, compared with the ilioinguinal approach, the modified Stoppa approach reduced intraoperative blood loss-and in doing so decreased wound drainage and the need for blood transfusion-and shortened operative time (all P<.05). The authors recommend using the modified Stoppa approach rather than the classical ilioinguinal approach to treat acetabular fractures when anterior exposure of the acetabulum is required.

Level II.

We previously reported that three point mutations in SASH1 and mutated SASH1 promote melanocyte migration in dyschromatosis universalis hereditaria (DUH) and a novel p53/POMC/Gαs/SASH1 autoregulatory positive feedback loop is regulated by SASH1 mutations to induce pathological hyperpigmentation phenotype. However, the underlying mechanism of molecular regulation to cause this hyperpigmentation disorder still remains unclear. In this study, we aimed to investigate the molecular mechanism undergirding hyperpigmentation in the dyschromatosis disorder. Our results revealed that SASH1 binds with MAP2K2 and is induced by p53‐POMC‐MC1R signal cascade to enhance the phosphorylation level of ERK1/2 and CREB. Moreover, increase in phosphorylated ERK1/2 and CREB levels and melanogenesis‐specific molecules is induced by mutated SASH1 alleles. Together, our results suggest that a novel SASH1/MAP2K2 crosstalk connects ERK1/2/CREB cascade with p53‐POMC‐MC1R cascade to cause hyperpigmentation phenotype of DUH.

Purpose The purpose of this study was to review the results of external fixation combined with vacuum sealing drainage (VSD) to treat patients who sustained tibial and fibular fractures in the Wenchuan earthquake. Methods We retrospectively analysed 179 cases (of which 85 were classified as Gustilo grade III) of open comminuted fracture of the tibia and fibula caused by the Wenchuan earthquake. The patients were followed up for an average of 15 months; detailed records were kept on their function and recovery. Results After caring for the life-threatening injuries; fractures were treated by external fixation, with VSD used on the surface or in the cavity of the wound after debridement. Antibiotics were administered on the basis of drug sensitivity test results. After the infection had been controlled and healthy granulation tissue had developed, the patients underwent secondary suture, free skin grafting, or skin flap transfer. Conclusion Good results can be achieved when external fixation combined with vacuum sealing drainage were used to treat open comminuted fractures of tibia and fibula in the Wenchuan earthquake.

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