[Gluteal posterior approach for surgery of the acetabulum]

This approach was developed to avoid gluteus maximus muscle injury which is divided when using the common Langenbeck-Kocher approach. The posterior perigluteal approach also provides better visualization of the posterior aspect of the acetabulum.

A semi-circular incision is made from the fascia lata at the anterior aspect of the greater trochanter and then directed to the posterio-superior iliac spine. The gluteus maxirnus is then simply retracted medially with blunt retractors. Sixty eight acetabular fractures have been operated with this approach including both mixed and complex fractures of the posterior column. Occasionally fractures of both columns have been operated in two procedures, one posterior and then a second anterior approach.

The posterior perigluteal approach preserves gluteus maximus muscle tone. It seems to avoid post-operative ossification.

We propose an approach which, compare to the Langenbeck- Kocher approach, is less traumatic, and as easy to perform.