Modified Ilio-femoral approach: An update

Area of Science:

• Orthopedic Surgery
• Trauma Surgery

Background:

• The iliofemoral approach, first described in 1967, has evolved through modifications to improve surgical access.
• The extended iliofemoral approach by Letournel further refined techniques for acetabular fracture management.

Purpose of the Study:

• To provide an update on the modified iliofemoral approach for acetabular and pelvic fractures.
• To evaluate the safety, efficacy, and complication profile of this surgical technique.

Main Methods:

• The modified iliofemoral approach involves osteotomy of the anterior superior iliac spine (ASIS).
• This technique was applied in 353 cases of acetabular and pelvic fractures.
• Surgical outcomes and complication rates were meticulously recorded.

Main Results:

• The approach provided excellent visualization of the anterior column, quadrilateral plate, and sacroiliac joint.
• Complications were minimal: 2% lateral femoral cutaneous nerve paresthesia, 0.5% ASIS screw prominence, and 4% deep surgical site infections.
• No cases of heterotrophic ossification were reported.

Conclusions:

• The modified iliofemoral approach is a safe, effective, and versatile technique for complex acetabular and pelvic fractures.
• It offers advantages over other approaches due to direct visualization and lower neurovascular injury risk.
• Further research is needed to establish its role in modern pelvic surgery and optimize training.