title: The modified ilioinguinal and anterior intrapelvic approaches for acetabular fracture fixation: indications, quality of reduction, and early outcome.
abstract: OBJECTIVE
  Traditionally, the anterior surgical approach of choice for acetabular reconstruction was ilioinguinal. There has been an increasing usage of the midline "Stoppa" or "anterior intrapelvic approach." The aim is to report the techniques, early results (minimum 1 year), and complications of anterior approaches for acetabular reconstruction.
  
  
  METHODS
  Retrospective case-note review.
  
  
  METHODS
  Pelvic and acetabular tertiary center.
  
  
  METHODS
  A consecutive series of acetabular fractures treated at 1 tertiary specialist unit were retrospectively reviewed. The fracture patterns, incisions used, intraoperative and postoperative complications, reduction achieved (measured on postoperative radiographs and computed tomography scans), and early postoperative results (minimum 1-year follow-up), were recorded.
  
  
  METHODS
  Postoperative reduction (measured by postoperative plain radiographs and computed tomography).
  
  
  RESULTS
  Of 160 consecutive patients who underwent acetabular reconstruction, 56 (mean age, 44 years) underwent reconstruction using only anterior approaches (mean of 7 days after injury). Iatrogenic complications, postoperative infection, arthritis, and avascular necrosis rates are comparable with the literature. Overall, anatomic reduction was seen in 71% of cases and concentric reconstruction of the dome in over 90%. Thirty-six of the 56 patients (64%) were symptom-free at the latest follow-up and 34 (61%) had returned to work.
  
  
  CONCLUSIONS
  The results reported suggest the use of dual approaches using the lateral 2 windows, and/or a midline anterior intrapelvic approach in anterior acetabular reconstructions has a relatively low complication rate and can lead to anatomic reconstructions in 71%.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Pelvic and Acetabular Reconstruction Unit, Trauma and Orthopaedic Department, North Bristol NHS Trust, Bristol, United Kingdom.
authors.forename: Tim J S
authors.initials: TJ
authors.lastname: Chesser
authors.forename: Will
authors.initials: W
authors.lastname: Eardley
authors.forename: Andrew
authors.initials: A
authors.lastname: Mattin
authors.forename: Amy M
authors.initials: AM
authors.lastname: Lindh
authors.forename: Mehool
authors.initials: M
authors.lastname: Acharya
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Ward
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult