Abstract
Posterior fractures of the acetabulum are the most frequent pattern of acetabular fractures. Based on the works of Judet and Letournel, accurate reduction and stable osteosynthesis with early mobilization have become the gold standard for the treatment of posterior acetabular fractures. Recently, a less invasive approach has been described to decrease Kocher-Langenbeck (K-L) approach complications. The clinical case describes a patient affected by two-column fractures of the acetabulum with skin abrasions of the gluteus. The clinical evaluation was based on Merle d’Aubigne and Postel scoring, which Matta has modified. The approach used is a modified, less invasive K-L: a straight skin incision from the midpoint between the posterior superior iliac spine and the posterior tip of the greater trochanter. We observed the essential advantages using this approach were a lesser split of the gluteus maximus and no risk of damage for the superior gluteal nerve. In the early postoperative rehabilitation, we examined the strength of the gluteus maximus, which was better than in patients treated with the typical Kocher–Langenbeck approach. The patient resumed after fifteen years after surgery; hip mobility is complete and painless.
Highlights
Over recent decades, minimally-invasive surgery has become a clinical trend because of its expected benefits, including less tissue trauma and early rehabilitation
Based on the works of Judet and Letournel, accurate reduction and stable osteosynthesis with early mobilization have become the gold standard for the treatment of posterior acetabular fractures
In the early postoperative rehabilitation, we examined the strength of the gluteus maximus, which was better than in patients treated with the typical Kocher–Langenbeck approach
Summary
Minimally-invasive surgery has become a clinical trend because of its expected benefits, including less tissue trauma and early rehabilitation. Orthopedic surgery has focused on minimizing the surgical approach and reducing the damage caused by invasive surgery. Many studies have shown that heterotopic ossification (HO) incidence is more significant in acetabular fracture surgery. This fact has been attributed to extended surgical approaches[3,4]. New surgical approaches have been proposed to reduce complications with the traditional K-L. B. Leach[5] and Spagnolo R. et al.[6] have described a K-L modification to reduce posterior acetabular fractures
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