Results of Modified Ilioinguinal Approach in Management of Acetabular and Pelvic Fractures (A Systematic Review and meta-analysis of Literature)

Abstract

Abstract Background Modified ilioinguinal approach was introduced to manage anterior acetabular fractures to reduce the morbidity & complications of the classic ilioinguinal approach, a less invasive anterior approach consisting of a medial window combined with the lateral window of the ilioinguinal approach. Aim of the Work a systematic review to determine whether the modified ilioinguinal approach is better the classic ilioinguinal approach in managing traumatic acetabular fractures by comparing the results in each study. Materials and Methods 5 studies(from 2010-2017) were included & reviewed the results of 147 patients operated by modified ilioinguinal approach in terms of: operative details, intraoperative & postoperative complications, postoperative reduction quality & final clinical outcome assessment, & results was analyzed & pooled together to reach a satisfactory outcome. Results Modified ilioinguinal approach showed operative time (123.2±6.83 minute), relatively small amount of blood loss (200-1000 ml) & better quality of reduction (84.8% had anatomical reduction, 10.9% had fair reduction, and 4.3% had poor reduction). However there were no significant differences in terms of postoperative complications & final clinical outcome assessment between different studies. Conclusion It was concluded that the modified ilioinguinal approach allowed reduction of anterior column and pelvic ring fractures without requiring dissection through the inguinal neurovascular structures. Results showed that its possible with this approach to reach safe reduction and stable fixation.