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International Orthopaedics
Published in: International Orthopaedics 6/2019

Open Access 01-06-2019 | Original Paper

The pararectus approach for internal fixation of acetabular fractures involving the anterior column: evaluating the functional outcome

Authors: Christian von Rüden, Lisa Wenzel, Johannes Becker, Andreas Thannheimer, Peter Augat, Alexander Woltmann, Volker Bühren, Mario Perl

Published in: International Orthopaedics | Issue 6/2019

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Abstract

Introduction

Aim of this retrospective analysis of prospectively collected data was to evaluate the functional mid-term outcome two years after open reduction and internal fixation of acetabular fractures involving the anterior column with affection of the quadrilateral plate using the pararectus approach on a large cohort.

Method

Fifty-two patients (12 female, 40 male) with a median age of 55 (range 18–90) years and displaced acetabular fractures involving the anterior column were surgically treated in a single level I trauma centre between July 2012 and February 2016 using the pararectus approach. Thirty-four patients (8 female and 26 male) with a median age of 58 (range 20–85) years were available for complete clinical follow-up at regular intervals, finally 24 months post-operatively. Functional outcome was evaluated according to modified Merle d’Aubigné score, Lower Extremity Functional Scale, WOMAC, and SF-36.

Results

Range of time between trauma and surgical treatment was three (range 0–19) days. Operation time was 140 (range 60–240) minutes, and duration of hospital treatment was 19 (range 7–38) days. Functional results in 34 patients available for final follow-up demonstrated 68 points (median; range 39–80) according to the Lower Extremity Functional Scale, 6% according to the WOMAC (mean; SD ± 14.5%), and 69% (mean; SD ± 20.1%) according to the SF-36. The modified Merle d’Aubigné score was excellent in 22 patients, good in eight patients, and fair in four patients.

Discussion/conclusion

Based on the good to excellent functional mid-term follow-up results of this study, the pararectus approach can be recommended as sufficient alternative single access to address displaced acetabular fractures involving the anterior column, independent of patients’ age.
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Metadata
Title
The pararectus approach for internal fixation of acetabular fractures involving the anterior column: evaluating the functional outcome
Authors
Christian von Rüden
Lisa Wenzel
Johannes Becker
Andreas Thannheimer
Peter Augat
Alexander Woltmann
Volker Bühren
Mario Perl
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 6/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4148-8

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