Author:
Lippross Sebastian,Wehrenpfennig Clara,Wedel Thilo,Seekamp Andreas,Osmonov Daniar,Moradi Babak,Fitschen-Oestern Stefanie,Finn Joerg,Klueter Tim,Kurz Bodo,Alkatout Ibrahim
Abstract
AbstractThe anterior ilioinguinal and the posterior Kocher-Langenbeck approach have long been the standard surgical approaches to the acetabulum. The last decade has witnessed the development of so-called intrapelvic approaches for anterior pathologies because they provide better exposure of the quadrilateral plate. Currently, the modified Stoppa approach and the pararectus approach are frequently used by surgeons for the treatment of acetabular fractures. We investigated an even more direct access to the entire anterior column and the quadrilateral plate via the abdominal wall muscles, between the incisions for the ilioinguinal and the pararectus approach.After intensive study of anatomic specimens, a cadaver dissection was performed prior to clinical application. The approach was then used in 20 patients who were assessed retrospectively.Postoperative CT scans showed that, according to the Matta scoring system, the quality of fracture reduction was “anatomical” (≤ 1 mm) in 12 (60%), “imperfect” (2–3 mm) in four (20%), and “poor” (> 3 mm) in four (20%) patients. Numerous minor complications were observed; the majority of these had resolved at the time of discharge.In conclusion, the anterior transmuscular intrapelvic approach (ATI) is a safe and effective alternative to the ilioinguinal and pararectal approaches, and may be regarded as an evolutionary advancement of traditional procedures.
Funder
Universitätsklinikum Schleswig-Holstein - Campus Kiel
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Rheumatology
Cited by
1 articles.
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