Advancement in the Stoppa approach in acetabular fractures

Abstract

The acetabular fractures are technically challenging due to the deep location in the pelvis and low degree of exposure. Although the classic ilioinguinal approach could treat most anterior acetabulum fractures, the limited surgical field and difficulty in exposure is the main obstacle surgeons should overcome. Various approaches including extended approaches and combined anterior and posterior approaches ensure adequate exposure, but high rate of complications impede it from clinical use. The Stoppa approach has been favored by the orthopedic surgeons in recent years for the minimized surgical dissection and good exposure. It allows for extensive visualization of the pelvic brim and direct manipulation of quadrilateral plate. This approach is indicated in all anterior column and wall fractures, combined anterior column and posterior hemi-transverse fractures, selected both-column fractures, transverse and T-fractures. The utilization of the Stoppa approach developed along with the evolution of the relevant theory of acetabular fractures in the past years. The development such as the precise measurement of safe zone and the application of new apparatus could do great help in decreasing the complications and improving the surgical results. This article summarizes the relevant literatures and provides a review of the advances in the Stoppa approach in acetabular fractures.