OUTCOMES OF EXTERNAL ROTATORS-SPARING APPROACH IN THE TREATMENT OF POSTERIOR WALL ACETABULAR FRACTURES: A RETROSPECTIVE STUDY

Document Type : Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations

Author

Orthopedic Surgery dept., Faculty of Medicine, Suez Canal Univ., Ismailia, Egypt

Abstract

Purpose: Posterior wall acetabular fractures are typically treated via a kocher-langenbeck approach.
This approach can be associated with complications such as avascular necrosis of the femoral head,
heterotopic ossification, sciatic neurapraxia and compromise of the hip muscle. In this study we assessed
clinical and radiological outcomes of muscle-sparing posterior approach for the treatment of posterior
wall acetabular fractures. Methods: This retrospective case series study included 37 cases of surgicallytreated posterior wall acetabular fractures using muscle-sparing posterior approach. It depended on
superior and inferior intermuscular windows for plate osteosynthesis. Cases were operated in the period
between March 2013 and January 2019 in orthopedic surgery department in the University Hospitals.
Clinical and radiographic assessment were assessed with minimum 3-years follow up utilizing the Merle
d’ Aubigne and Matta scoring systems respectively. Results: The mean patients’ age was 38.8 ± 11.1
years. Average operative time was 60.3 min. Average intra-operative blood loss was (123.9±10.5 ml).
There were no cases of avascular necrosis of the femoral head. Anatomical reduction was achieved in 31
hips (83.8%). At one-year follow-up, final Merle d’ Aubigne scores were excellent in 27 hips (73%),
good in seven hips (18.9%). Cases with anatomical reduction revealed clinically excellent results in 27
cases (87.1%), good in three cases (9.1%). Conclusion: External rotators-sparing approach may be
considered as alternative to conventional Kocher-Langenbeck approach in posterior wall acetabular
fractures treatment, with good results and few complications

Keywords

Egyptian Journal of Orthopedic Research
Volume 3, Issue 2
December 2022
Pages 55-61

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