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Surgical Treatment of Displaced Acetabular Fractures Using a Modified Stoppa Approach.

Mehmet Elmadag, Yunus Guzel, Yusuf Aksoy

|February 26, 2016

Summary

The modified Stoppa approach effectively treats displaced acetabular fractures, achieving anatomical reduction in 80.5% of patients. This surgical technique offers a viable alternative for complex hip injuries.

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Area of Science:

Orthopedic Surgery
Trauma Surgery
Skeletal Radiology

Background:

Displaced acetabular fractures present complex surgical challenges.
The ilioinguinal approach is a traditional method, but alternative approaches are sought for improved outcomes.
The modified Stoppa approach offers potential advantages for accessing and reducing acetabular fractures.

Purpose of the Study:

To evaluate the efficacy and outcomes of the modified Stoppa approach in treating displaced acetabular fractures.
To assess the radiological and functional results following surgical intervention.
To compare the modified Stoppa approach with existing surgical methods.

Main Methods:

A retrospective review of 36 patients with displaced acetabular fractures treated with the modified Stoppa approach.
Classification of fractures using the Judet and Letournel system.
Pre- and postoperative assessment of fracture displacement and gap using computed tomography (CT) scans.
Evaluation of functional outcomes using range of motion, Harris Hip Scores, and Merle d'Aubigné scores.

Main Results:

Anatomical reduction was achieved in 80.5% of patients, with satisfactory reduction in an additional 13.8%.
Mean postoperative displacement was significantly reduced to 0.2-0.3 mm across axial, coronal, and sagittal planes.
Mean functional scores (Harris Hip Score 77.9, Merle d'Aubigné 16.4) and range of motion (flexion 105.2°) indicated positive outcomes.
Complications included foot drop (2 patients), nerve damage (1 patient), vascular injury (1 patient), and avascular necrosis (1 patient).

Conclusions:

The modified Stoppa approach is an effective surgical option for a wide range of complex acetabular fractures.
Despite a learning curve, this approach provides excellent radiological reduction and good functional outcomes.
It represents a valuable alternative to the traditional ilioinguinal approach in acetabular fracture management.