Fixation of acetabular fractures via the ilioinguinal versus pararectus approach: a direct comparison.
This study compared the quality of reduction and complication rate when using a standard ilioinguinal approach and the new pararectus approach when treating acetabular fractures surgically. All acetabular fractures that underwent fixation using either approach between February 2005 and September 2014 were retrospectively reviewed and the demographics of the patients, the surgical details and complications were recorded. A total of 100 patients (69 men, 31 women; mean age 57 years, 18 to 93) who were consecutively treated were included for analysis. The quality of reduction was assessed using standardised measurement of the gaps and steps in the articular surface on pre- and post-operative CT-scans. There were no significant differences in the demographics of the patients, the surgical details or the complications between the two approaches. A significantly better reduction of the gap, however, was achieved with the pararectus approach (axial: p = 0.025, coronal: p = 0.013, sagittal: p = 0.001). These data suggest that the pararectus approach is at least equal to, or in the case of reduction of the articular gap, superior to the ilioinguinal approach. This approach allows direct buttressing of the dome of the acetabulum and the quadrilateral plate, which is particularly favourable in geriatric fracture patterns.
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
S
S
Märdian
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
K D
KD
Schaser
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
P
P
Hinz
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
S
S
Wittenberg
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
N P
NP
Haas
Charité - university medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
P
P
Schwabe
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
acetabular fractures; buttressing; ilioinguinal approach; pararectus approach; quadrilateral plate; reduction quality