Operative treatment of acetabular fractures through the ilioinguinal approach: a 10-year perspective

The ilioinguinal surgical approach was found to be effective for treatment of 119 (about 33%) of the 373 acetabular fractures treated operatively by the author over a 10-year period. It is indicated for anterior wall, anterior column, associated anterior and posterior hemitransverse fractures, as well as certain both column and transverse fractures. The approach offers the advantages of a cosmetic incision, rapid recovery of muscle function, and minimal ectopic bone formation. Complications included 3% surgical wound infection, 2% iatrogenic nerve palsy, 1% significant ectopic bone, and 1% death from pulmonary embolus. Clinical results at a minimum of 1-year, and an average of 3-years' followup, were excellent in 37%, good in 47%, fair in 14%, and poor in 2%. Two patients later required total hip arthroplasty for posttraumatic arthritis.