Complex Acetabular Fractures

Goulet, James A.; Bray, Timothy J.

doi:10.1097/00003086-198903000-00004

Cited by 74 publications

(51 citation statements)

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“…Operative approaches to the acetabulum generally can be classified as anterior, posterior, extensile, or combined and largely include the Kocher-Langenbeck, iliofemoral, ilioinguinal, extended iliofemoral, triradiate, and combined anterior and posterior approaches [1,2]. Since the original description by Letournel in 1961 [9], the ilioinguinal approach has remained the workhorse approach for anterior acetabular fixation.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Acetabulum Fractures Through the Modified Stoppa Approach: Strategies and Outcomes

Isaacson

Taylor

French

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Since the original description by Letournel in 1961, the ilioinguinal approach has remained the predominant approach for anterior acetabular fixation. However, modifications of the original abdominal approach described by Stoppa have made another option available for reduction and fixation of pelvic and acetabular fractures. Questions/purposes We evaluated our results in patients with acetabulum fractures with the modified Stoppa approach in terms of (1) hip function as measured by the Merle d'Aubigne hip score; (2) complications; and (3) quality of fracture reduction and percentage of fractures that united. Methods Between September 2008 and August 2012, 289 patients with acetabular fractures were treated at our Level I trauma center. Twelve percent (36 of 289) of patients were treated operatively using the modified Stoppa approach. Ninety-seven percent (35 of 36) of our patients had fracture patterns involving displacement of the posterior column. Six (17%) were converted early to a total hip arthroplasty, and 14 (39%) were lost to final followup, leaving 22 of 36 for subjective clinical outcome analysis at a mean of 32 months (range, 9-59 months). Our general indications for this approach during the period in question were fractures of the anterior column and anterior wall, anterior column with posterior hemitransverse fractures, both column fractures, transverse fractures, and T-type fractures. Followup included regularly scheduled office visits with radiographs (AP pelvis, Judet views) that were graded by the treating surgeon and by the authors of this study (MJI, BCT) and patient outcome surveys.One of the authors (BCT) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period of less than USD 10,000 from DepuySynthes (DePuy Orthopaedics, Inc, Warsaw, IN, USA), Orthobullets.com for editorial staff services (Lineage Medical, LLC, Cambridge, MA, USA), and research grant support from Synthes and the Orthopaedic Trauma Association. One of the authors (BGF) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period of less than USD 10,000 from Biomet (Biomet, Inc, Warsaw, IN, USA) and is on the speakers' bureau for DepuySynthes. One of the authors (AP) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period of less than USD 10,000 from Biomet and Stryker (Kalamazoo, MI, USA). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Results Merle d'Aubigne hip scores were very good in 55% (12 of 22), good in 9% (two of 22),...

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Section: Introductionmentioning

confidence: 99%

Treatment of Acetabulum Fractures Through the Modified Stoppa Approach: Strategies and Outcomes

Isaacson

Taylor

French

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Nowadays, open reduction and internal fixation is the standard treatment for displaced acetabular fractures. Generally, surgical approaches to the acetabulum can be classified as anterior, posterior, extensile, or combined and mostly include the ilioinguinal, iliofemoral, extended iliofemoral, Kocher-Langenbeck, triradiate, and combined anterior and posterior approaches [7,8].…”

Section: Introductionmentioning

confidence: 99%

Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

Mesbahi

Ghaemmaghami

et al. 2018

BEAT

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Objective: To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures. Methods: This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016. Functional and radiographic outcomes, and complication were considered as main outcomes. Results: A total number of 79 patients completed the study. Fifty-five patients were operated through KocherLangenbeck approach, and 18 were operated through the standard ilioinguinal approach, and 6 patients were operated through the standard ilioinguinal approach combined with Kocher-Langenbeck approach. The mean follow-up of patients was 45.6 months. The average operative time was 162.4±78.5 min, and the median blood loss was 500 ml. Functional results were excellent in 41 patients (51.9%), good in 12 (15.2%), fair in 13 (16.5%), and poor in 13 patients (16.5%). Radiologic results were excellent in 27 cases (34.2%), good in 17 cases (21.5%), fair in 18 cases (22.8%), and poor in 16 (16.5%). Osteoarthritis of hip (60.8%) and AVN of head of femur (22.8%) were two most common complications. In addition, there wasn't any significant difference between surgical approaches regarding clinical and radiographic outcomes. Conclusion: The operative treatment for acetabular fractures gives universally satisfactory results. Thereafter, this study provides evidence that ilioinguinal approach is a good choice for anterior fractures, KocherLangenbeck is a good choice for posteriors fractures, and combined approach may be a good choice in the management of acetabular fractures involving two columns.

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“…Procedures using plates or lag screws, or both in combination, have been advocated for fixation of posterior column fractures [3,5,7,10,14]. Few studies have assessed the biomechanical efficacy of the fixation methods of acetabular fractures [6,13], while none have considered posterior column fractures which occur frequently in high energy fractures of the acetabulum.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of methods of fixation of isolated osteotomies of the posterior acetabular column

Schopfer

DiAngelo

Hearn

et al. 1994

International Orthopaedics

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Ten fresh frozen specimens of a hemipelvis, including the hip joint, capsule and proximal femur, from elderly cadavers were used to evaluate three methods of internal fixation of isolated posterior column osteotomies. Intact and reconstructed specimens were tested at 30 degrees and 60 degrees of hip flexion in a specially designed joint simulator. The three methods of fixation used were a single 3.5 mm reconstruction plate, two such plates, and a 4.5 mm lag screw with a single plate. Motion at the fracture site in three orthogonal directions, and the overall stiffness of the construct, were recorded simultaneously. No significant differences were noted in stiffness for the three procedures and all retained 80% of the intact stiffness. At 60 degrees of flexion, smaller interfragmentary compliances were allowed by fixation with a lag screw and a neutralisation plate (p < 0.05). At 30 degrees, the position of the load plane relative to the fracture plane allowed less interfragmentary motion, so that no significant differences were found between the 3 methods.

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Complex Acetabular Fractures

Cited by 74 publications

References 1 publication

Treatment of Acetabulum Fractures Through the Modified Stoppa Approach: Strategies and Outcomes

Treatment of Acetabulum Fractures Through the Modified Stoppa Approach: Strategies and Outcomes

Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

Biomechanical comparison of methods of fixation of isolated osteotomies of the posterior acetabular column

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