Modified Stoppa approach can effectively treat complex acetabular fractures
Researchers of this retrospective study found that despite its steep learning curve, a modified Stoppa approach can be a suitable alternative to an ilioinguinal approach to treat patients with displaced acetabular fractures.
Researchers included 36 patients in the retrospective evaluation. According to the Judet and Letournel classification, fractures included 18 anterior columns, two both columns, eight anterior columns with posterior hemitransverse, six transverse and two T-type. All patients were treated with a modified Stoppa approach, rather than the common ilioinguinal approach for anterior acetabular fractures.
In all patients, fixation was achieved with a 3.5-mm pelvic reconstruction plate and screws.
Patients were followed for a mean of 14.7 months, and the mean estimated blood loss was 970 mL. According to researchers, the mean preoperative gap was 13.3 mm and the mean postoperative gap was 1.4 mm. At initial follow-up, the mean Harris hip score was 77.9 and the mean Merle d'Aubigné score was 16.4.
However, foot drop was reported in two patients and sciatic symptoms also occurred, which researchers noted may have been due to a posterior hemitransverse fracture. Within 6 months, the patients began to function properly.
“The modified Stoppa approach, which provided successful reduction of anterior column fractures and their components, including some complex acetabular fractures, is an alternative technique to the ilioinguinal approach. However, although the functional outcomes are successful, there is a steep learning curve for this technique due to the proximity of neurovascular structures,” researchers wrote in the study. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.