Management of complex acetabular fractures through single nonextensile exposures

A review of 127 surgically treated acetabular fractures, treated between August 1986 and January 1991, using single nonextensile surgical exposures and indirect reduction techniques was conducted. There were 31 elementary and 96 associated fractures (Letournel). In 34 cases the fracture involved only one column and in nine cases an extensile or combined exposure was required, therefore these cases were excluded from the study. This left 84 complex fractures (involving two column) for review. In all cases either the anterior (ilioinguinal) or posterior (Kocher-Langenbeck) exposure was used. Indirect reduction of the involved and opposite column was achieved with either the Judet table, lateral trochanteric traction, or the femoral distractor. A satisfactory reduction was obtained in 90.5% (76 of 84) of the cases (concentric, gap < 3 mm, step off < 2 mm). The incidence of acute infection and heterotopic ossification was 0% and 2%, respectively.