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European Journal of Trauma and Emergency Surgery

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Open Access 01-04-2022 | Acetabular Fracture | Original Article

Early biomechanical outcome in patients with acetabular fractures treated using the pararectus approach: a gait and stair climb analysis study

Authors: Andreas Brand, Christian von Rüden, Carina Probst, Lisa Wenzel, Peter Augat, Mario Perl

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

Abstract

Purpose

Patients with surgically treated acetabular fractures using extensive dissection of hip muscles demonstrate an incomplete biomechanical recovery and limited joint mobility during movement. The purpose of this study was to evaluate the early biomechanical outcome in a series of patients with acetabular fractures treated using the less invasive anatomical pararectus approach.

Methods

Eight patients (48 ± 14 years, BMI 25.8 ± 3 kg/m²) were investigated 3.8 ± 1.3 months after surgery and compared to matched controls (49 ± 13 years, BMI 26 ± 2.8 kg/m²). Trunk and lower extremity kinematics and kinetics during gait and stair climb were calculated. SF-12 and the Merle d’Aubigné score were used for functional evaluation. Statistical analysis was conducted using Mann–Whitney test and Student’s t test. Effect sizes were calculated using Cohen’s d.

Results

No group differences for lower extremity kinematics during walking and stair climbing were found. During walking, patients showed significant reductions (p < 0.05) of the vertical ground reaction force (8%) and knee and hip extension moments (29 and 27%). Ipsilateral trunk lean was significantly increased by 3.1° during stair descend while reductions of vertical ground reaction force were found for stair ascend (7%) and descend (20%). Hip extension moment was significantly reduced during stair descend by 37%. Patients revealed acceptable SF-12 physical and mental component outcomes and a good rating for the Merle d’Aubigné score (15.9 ± 1.7).

Conclusion

Patients showed some biomechanical restrictions that can be related to residual deficits in weight bearing capacity and strength of the hip muscles. In contrast, an immediate recovery of mobility was achieved by preserving lower extremity and pelvic movement. Therefore, the pararectus approach can serve as a viable strategy in the surgical treatment of acetabular fractures.

Clinical trial

Trial registration number DRKS00011308, 11/14/2016, prospectively registered.

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Title: Early biomechanical outcome in patients with acetabular fractures treated using the pararectus approach: a gait and stair climb analysis study
Authors: Andreas Brand
Christian von Rüden
Carina Probst
Lisa Wenzel
Peter Augat
Mario Perl
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keyword: Acetabular Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01655-7

At a glance: The STEP trials

Springer Medicine

Early biomechanical outcome in patients with acetabular fractures treated using the pararectus approach: a gait and stair climb analysis study

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial

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