title: Management of acetabular fractures with modified posterior approach to spare external hip rotators.
abstract: BACKGROUND
  In the present study the quality of reduction and incidence of complications in hip external rotator sparing modified posterior approach was assessed in both simple and complex acetabular fractures.
  
  
  METHODS
  This retrospective study includes 37 patients (38 hips) with a mean age of 42.1 years (range 21-60), that had been treated for displaced acetabular fractures from June 2007 through May 2011. They were reviewed at a mean of 3 years (20-67 months).
  
  
  RESULTS
  The fractures were classified according to the Letournel-Judet classification. Anatomic reduction and stable fixation of the fracture with less than 2mm residual displacement was achieved in 28 of 38 hips. At the final follow up the patients were evaluated clinically according to Merle d'Aubigne and Postel scoring system which had been modified by Matta and radiologically based on the criteria described by Matta. The clinical results were excellent in 20, good in 8, fair in 8, and poor 2 hips. Complications included two superficial local wound infection and 10 heterotopic ossification with 7 of the cases having grade I heterotopic ossification. Avascular necrosis of the femoral head was not seen in any of the 38 hips. One patient with preoperative sciatic nerve palsy had complete recovery of neurologic function. There were no cases of deep vein thrombosis or pulmonary embolism.
  
  
  CONCLUSIONS
  The functional outcome was satisfactory in most of the cases and comparable with other larger series. Using the limited part of Henry's sciatic nerve exposure skin incision - working in the plane between gluteus maximus and the tensor fascia lata as in the classical Gibson approach and two portal external rotator hip sparing approach resulted in good fracture reduction without approach related complications.
authors.affiliation: Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey. Electronic address: kouortopcom@yahoo.com.
authors.forename: Ahmet Y
authors.initials: AY
authors.lastname: Sarlak
authors.affiliation: Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Selek
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Inanir
authors.affiliation: Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey.
authors.forename: Resul
authors.initials: R
authors.lastname: Musaoglu
authors.affiliation: Department of Orthopaedics and Traumatology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Baran
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000328:Adult; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acetabular fracture; Modified posterior acetabular approach; Short external rotator sparing