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Anterior intrapelvic approach for acetabular fractures yielded anatomic reduction
Most geriatric patients with unstable acetabular fractures experienced anatomic or at minimum imperfect fracture reduction after treatment with an anterior intrapelvic approach that used approach-specific instruments and anatomical-preshaped, 3-D suprapectineal plates, according to results.
Florian Gras, MD, and colleagues analyzed 30 patients (mean age: 64 years) with unstable acetabular fractures fixed with anatomical-preshaped, 3-D suprapectineal plates (Pelvic Pro System; Stryker GmbH) through the anterior intrapelvic approach either with or without the first window of the ilioinguinal approach. Researchers measured fracture reduction results using CT scans and graded according to the Matta quality of reduction, as well as recorded intraoperative parameters and perioperative complications. At 1-year follow-up, researchers evaluated radiological results and function.
Results showed 19 cases underwent the intrapelvic approach alone vs. 11 cases that underwent an additional extension with the first window of the ilioinguinal approach. Researchers noted a mean operative time of approximately 202 minutes and a fluoroscopic time of approximately 66 seconds. Preoperative CT scans revealed fractures gaps of approximately 12.4 mm vs. 2 mm in postoperative CT scans, according to results. Researchers also found preoperative and postoperative CT scans of fractures steps were approximately 6 mm vs. 1.3 mm, respectively. Matta grading was excellent in 50%, good in 25%, fair in 11% and poor in 14% of cases at approximately 13.4 months follow-up, while the modified Merle d’Aubugné score was excellent in 17%, good in 37%, fair in 33% and poor in 13% of cases. – by Casey Tingle
Disclosures: Gras reports instructor agreements for pelvic trauma courses of Stryker Orthopedics. Please see the full study for a list of all other authors’ relevant financial disclosures.