Simultaneous anterior and posterior approaches for complex acetabular fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Reconstruction

Background:

• Acetabular fractures present complex surgical challenges.
• Extensile exposures are often required but can lead to significant morbidity.
• Minimally invasive or alternative approaches are sought to improve outcomes.

Purpose of the Study:

• To evaluate the safety and utility of simultaneous Kocher-Langenbeck and iliofemoral approaches for acetabular fracture fixation.
• To compare the morbidity of this combined approach with traditional extensile exposures.
• To identify specific fracture patterns where this combined approach is most beneficial.

Main Methods:

• A combined Kocher-Langenbeck (posterior) and iliofemoral (anterior) surgical exposure was utilized.
• Acetabular fractures were approached simultaneously through these two portals.
• Patient outcomes and complication rates were assessed and compared to historical data from extensile exposures.

Main Results:

• The simultaneous Kocher-Langenbeck and iliofemoral approach is a safe and useful alternative for acetabular fracture exposure.
• This combined approach can be performed with morbidity comparable to other extensile exposures.
• A key advantage is the avoidance of trochanteric osteotomy, preserving hip biomechanics.

Conclusions:

• The simultaneous anterior and posterior approach provides a viable alternative to extensive surgical exposures for acetabular fractures.
• This technique is particularly advantageous for complex fracture patterns, including transverse, T-type, and both-column fractures with posterior wall involvement.
• The absence of trochanteric osteotomy is a significant benefit of this combined surgical strategy.