Surgical treatment of acetabular fracture

Abstract

The kocher -Langenbeck approach is the best suited approach for reduction and fixation of acetabular fracture that require fixation through posterior approach and provides sufficient access to the majority of posterior based acetabular fracture. Accuracy of fracture reduction is the strongest predictor of clinical outcome in acetabular fixation surgery.Twenty four patients with posteriorly based acetabular fracture were treated with open reduction and internal fixation using Kocher- Langenbeck incision. In our series, there were 11 posterior wall, 3 posterior column, 5 transverse, 2 posterior column and posterior wall and 3 transverse and posterior wall fractures. All the patients were in the age group of 30 to 45 years (mean age 38.5 years). Males dominated our series (n=18 i.e. 75%) and right side was more commonly involved in both the sexes (n=14 i.e. 58.33%). Road traffic accident was the leading cause (n=19 i.e. 79.16%). All the patients were operated achieving adequate stability and with utmost soft tissue care. Follow up radiograph were graded according to criteria developed by Matta J et al. A minimum follow up was two years. Patient with accurate reconstruction (n =21 i.e. 87.50%) had good or excellent functional outcome while two patients (08.33%) with inaccurate reduction and one patient (04.16%) with poor reduction had fair and poor outcome respectively. Despite relatively large number of possible complications Kocher–Langenbeck Approach is the best suited approach for posterior acetabular fracture.