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BMC Musculoskeletal Disorders

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01-12-2022 | Acetabular Fracture | Research

The Kocher-Langenbeck approach combined with robot-aided percutaneous anterior column screw fixation for transverse-oriented acetabular fractures: a retrospective study

Authors: Zhao-jie Liu, Ya Gu, Jian Jia

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Objective

Transverse-oriented acetabular fractures (TOAFs), including transverse, transverse with posterior wall and T-shaped fractures, are always challenging for double-column reduction and fixation with minimally invasive method. The purpose of this study is to compare the therapeutic effects of robot-aided percutaneous anterior column screw fixation versus minimally invasive anterior plate fixation for TOAFs based on the Kocher-Langenbeck (K-L) approach.

Methods

Patients suffering TOAFs that were fixed by robot-aided percutaneous anterior column screw fixation or minimally invasive anterior plate fixation associated with posterior fixation via the K-L approach were divided into two groups: group A (screw fixation) and group B (plate fixation). Surgical time, blood loss, incision length for anterior fixation and complications were recorded. Fracture reduction quality was evaluated using criteria described by Matta. Fracture healing was assessed on the series of pelvic radiographs at each follow-up. Functional outcomes were investigated using the modified Postel Merle D’Aubigne score at the final follow-up.

Results

Twenty-nine patients with TOAFs, including 12 patients in group A and 17 patients in group B, were evaluated for study eligibility. The mean surgical time of anterior fracture fixation was 18.7 ± 4.6 min in group A and 33.4 ± 5.0 min in group B (P < 0.001). The amount of intraoperative blood loss was 615.6 ± 178.7 ml in group A and 719.3 ± 199.0 ml in group B (P < 0.001). Incision length for anterior fixation was 9.0 ± 1.8 mm in group A and 81.2 ± 7.3 mm in group B (P < 0.001). The complications related to the surgery of anterior column only occurred in group B (lateral femoral cutaneous nerve palsy in 1 patient and groin discomfort in 1 patient). No significant differences in reduction quality, hospital stay, fracture healing time and functional results were noted between the two groups.

Conclusion

The K-L approach combined with robot-aided anterior column screw fixation is a safe and effective option for TOAFs. Compared with minimally invasive anterior plate fixation, robot-aided screw fixation has obvious advantages on surgical time, blood loss, and invasiveness. The K-L approach combined with minimally invasive anterior plate fixation can also be a reliable alternative for TOAFs, with the similar reduction quality and functional results.

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Title: The Kocher-Langenbeck approach combined with robot-aided percutaneous anterior column screw fixation for transverse-oriented acetabular fractures: a retrospective study
Authors: Zhao-jie Liu
Ya Gu
Jian Jia
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Acetabular Fracture
Incision
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05313-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Kocher-Langenbeck approach combined with robot-aided percutaneous anterior column screw fixation for transverse-oriented acetabular fractures: a retrospective study

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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