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Rationales for the Bernese approaches in acetabular surgery
M J B Keel1, T M Ecker, K-A Siebenrock
1Department of Orthopedic and Trauma Surgery, University Hospital Bern Inselspital, Freiburgstrasse 3, Bern, Switzerland.
Summary
Two novel Bernese approaches, the trochanteric flip osteotomy and Pararectus approach, enhance visualization and anatomical reconstruction for acetabular fractures. These techniques aim to improve outcomes for complex fractures, potentially reducing poor results.
Area of Science:
- Orthopedic surgery
- Traumatology
- Surgical anatomy
Background:
- Acetabular fractures present complex challenges in surgical management.
- Existing approaches may have limitations in visualization and anatomical reconstruction.
- There is a need for improved surgical techniques to address complex acetabular fractures.
Purpose of the Study:
- To introduce and describe two novel surgical approaches for acetabular fractures developed in Berne.
- To enhance visualization and facilitate anatomical reconstruction of acetabular fractures.
- To evaluate the potential of these new techniques in managing complex acetabular injuries.
Main Methods:
- The trochanteric flip osteotomy was utilized for posterior acetabular fractures, enabling surgical hip dislocation.
- The Pararectus approach was employed for anterior column and quadrilateral plate fractures.
- Both approaches focus on direct visualization and anatomical reduction.
Main Results:
- The trochanteric flip osteotomy provided excellent exposure for anatomical reduction and screw placement, and allowed for salvage procedures like osteochondral transplantation.
- The Pararectus approach achieved anatomical restoration with minimal morbidity, combining benefits of other established approaches.
- Both techniques facilitate precise fracture reduction and fixation.
Conclusions:
- The trochanteric flip osteotomy improves visualization of the acetabulum and allows treatment of associated chondral and labral lesions.
- The Pararectus approach effectively addresses displaced anterior column fractures with minimal surgical morbidity.
- Further long-term studies are required to confirm if these Bernese approaches can reduce the rate of poor outcomes in complex acetabular fractures.
