Complications following the "T extensile" approach: a modified extensile approach for acetabular fracture surgery-report of forty-three patients.
OBJECTIVE
Analyze the prevalence and severity of surgical complications encountered with a modified extended iliofemoral approach, the "T extensile" approach, in the treatment of complex acetabular fractures.


METHODS
Prospective.


METHODS
During a sixteen-month study period, forty-three patients with complex acetabular fractures were treated via the T extensile approach. Perioperative antibiotics were used to prevent infection, and prophylaxis for heterotopic ossification was done with postoperative irradiation. Complications and clinical results were recorded. The patients were followed for an average of thirty months.


RESULTS
Acceptable reductions were obtained in forty patients. Poor reductions were obtained in three patients. There were no infections or iatrogenic nerve injuries. Brooker Grade 1 heterotopic ossification was seen in nineteen patients, eight had Grade 2, two had Grade 3, and no heterotopic ossification was seen in the other fourteen patients. No patient who received radiation developed heterotopic ossification beyond Brooker Grade 2. Seven patients went on to require total hip arthroplasty. The remaining thirty-six patients had an average Harris Hip Score of 86.


CONCLUSIONS
Extensile exposures to the acetabulum can be safely carried out with limited morbidity, as long as appropriate steps are taken to limit predictable complications.
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000009:adverse effects*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D015599:Trauma Severity Indices; D016896:Treatment Outcome