Newly modified Stoppa approach for acetabular fractures
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ORIGINAL PAPER
Newly modified Stoppa approach for acetabular fractures Yong Liu & Hao Yang & Xiang Li & Shu Hua Yang & Jian Hua Lin
Received: 24 April 2013 / Accepted: 25 April 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose We present our experience of using a newly modified Stoppa approach combined with a lateral approach to the iliac crest in patients with acetabular fractures in reference to fracture reduction and fixation, technical aspects, and the incidence of complications. Methods We used a consecutive group of 29 adult patients with acetabular fractures treated operatively with a newly modified Stoppa approach between 2009 and 2011. The newly modified Stoppa approach was performed to fix the acetabular fractures with main anterior displacement and the anterior and lateral parts of the pelvis. This approach was combined with a lateral approach on the iliac crest for fractures of the iliac wing. Results All the patients were followed up for at least 1.5 years. Of the 29 patients, ten anterior column, two associated both column, seven anterior column with posterior hemi-transverse, four transverse, and six T-type fractures. The average blood loss was 950 mL, and average operative time was 155 minutes. Anatomic or satisfactory reduction was achieved in 96 % of the acetabular fractures. Two patients had mild symptoms of the lateral femoral cutaneous nerve and improved within three months. Conclusions The newly modified Stoppa approach provides excellent visualization to the anterior column, quadrilateral surface and permits good postoperative results for treatment Y. Liu : X. Li (*) : S. H. Yang Department of Orthopedics, Union Hospital, Tongji Medical College, University of Science and Technology, Wuhan, China e-mail: [email protected] H. Yang Department of Orthopedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China X. Li : J. H. Lin Department of Orthopedics, First Clinical Medical College of Fujian Medical University, Fuzhou, China
of acetabular fractures. We considered this technique as a viable alternative for the ilioinguinal approach when exposure of the anterior acetabulum is needed.
Introduction Surgical management of displaced acetabular fractures has become the gold standard after the early work of Letournel [1–4]. The surgical decision making entails the fracture classification and operative approach. The choice of operative approach is dependent on the fracture type, direction of displacement, skin situation at the surgical incision site, and duration from initial injury [5–7]. Generally, the operative approaches to the acetabulum fractures can be classified into anterior, posterior, extensile and combined approaches. Those fractures with the main anterior displacement are approached anteriorly, while those with the main posterior displacement are approached posteriorly. A combined or extended approach is used if the displacement involves both the anterior and posterior parts of the acetabulum. Although the extended and combined approaches provide excellen
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