Randomized, controlled trial of the modified Stoppa versus the ilioinguinal approach for acetabular fractures

The objective of this study was to determine whether the modified Stoppa approach or the ilioinguinal approach is better for the treatment of acetabular fractures by comparing the results of those 2 approaches. A randomized trial was undertaken of 60 consecutive patients with acetabular fractures treated with either the modified Stoppa or the ilioinguinal approach. In addition to the patients' demographics, the assessed preoperative parameters included fracture pattern, associated injuries, time to surgery, and Injury Severity Score; intraoperative parameters included blood loss and operative time for each procedure; and postoperative parameters included wound drainage, blood transfusion, perioperative complications, early operative complications, late operative complications, quality of reduction, radiological results, and clinical outcomes. The study showed no significant differences in all measured preoperative variables between the 2 groups (all P>.05). In addition, no significant differences were found in the intraoperative complication rate, early operative complication rate, late operative complication rate, quality of reduction, radiological results, and clinical outcomes (all P>.05). However, compared with the ilioinguinal approach, the modified Stoppa approach reduced intraoperative blood loss-and in doing so decreased wound drainage and the need for blood transfusion-and shortened operative time (all P<.05). The authors recommend using the modified Stoppa approach rather than the classical ilioinguinal approach to treat acetabular fractures when anterior exposure of the acetabulum is required.