Rationale for more consistent choice of surgical approaches for acetabular fractures

Associated both-column acetabular fracture: An overview of operative steps and surgical technique

“…23 The use of extensile approaches, such as the extended iliofemoral approach suggested by Pierannunzii et al, has been associated with more complications. 5,24 In our hands, the extended iliofemoral approach is reserved for selected cases of delayed or malunited acetabular fracture reconstruction. In this situation, it may be helpful to debride the soft tissue scarring and remove fracture callus.…”

“…1 Although the majority of both-column acetabular fracture patterns can be treated successfully through a single approach, it is strongly recommended that the surgeon dealing with these fracture types be familiar with the different approaches to the acetabulum and be prepared to perform them during the same operative procedure. 24 Of extreme importance, patient and/or relatives should be informed about the possibility of more than one surgical incision and the potential operative risks, such as iatrogenic nerve or vessel injury, nonanatomic fracture reduction, and articular hardware penetration. 16,25…”

Application of a three-dimensional virtual model to study the effect of fluoroscopic angle on infra-acetabular corridor parameters and screw insertion rates

“…When the concept of IAS was first introduced by Culemann, it was considered only applicable to fracture types handled by the ilioinguinal approach (anterior column, anterior column with posterior semi-transverse, T-shape, and double-column fractures), which are driven from the second window, hence the name “second window screws” [ 10 ]. Gusic et al [ 1 ] reported retrograde IAS insertion via the posterior K–L approach to fix T-shape with posterior wall fractures and hip dislocation, which first introduced the concept of retrograde IAS. In terms of surgical operation, three-dimensional navigation and electromagnetic navigation techniques have also been applied to screw insertion, and the development of new technologies has undoubtedly helped to shorten the operating time, improve the accuracy of screw insertion, and reduce the radiation dose to the doctor and patient [ 19 , 20 ].…”

“…Acetabular fractures are usually intra-articular fractures caused by high-energy injuries. Open reduction and internal fixation have become the standard method for the treatment of unstable acetabular fractures [ 1 ]. However, due to the deep location of the acetabulum, the complicated anatomy of the surrounding soft tissues, and the limited intraoperative field of view, it is easy to cause iatrogenic injuries.…”

Articular impaction injuries in the lower limb

“…29-31 Age alone is not a contra-indication to operative management as the outcome of total hip arthroplasty (THA) in patients with unreduced acetabular fractures is worse than those who had open reduction and internal fixation (ORIF) prior to THA. 32 …”