Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hip
Abstract number: 26720
MINIMALLY INVASIVE APPROACH FOR ACETEBULAR FRACTURES -
MODIFIED STOPPA APPROACH WITH OR WITHOUT LATERAL WINDOW -
Ken'ichi OGAWA 1 , Taieshi DOI 1 , Masanori YORIMITSU 1 , Kazuo MUNETOMO 1 ,
Tomoyuki NODA 2 , Toshifumi OZAKI 2
1 Fukuyama City Hospital Emergency Medical Center, Hiroshima (JAPAN), 2 Okayama
University Medical School, Okayama (JAPAN)
INTRODUCTIONIlioinguinal approach is the golden standard for the operation of
acetabular fractures. It can visualize 1) iliacus and sacroiliac joint through 1st (iliac)
window, 2) iliopubic eminence and anterior wall thorough 2nd (between iliacus
muscle and femoral vessels) window, and 3) symphysis pubica and pubic rami
though 3rd (just above the symphysis pubica) window. Recently, 3rd window is used
as Modified Stoppa approach, which can well visualize quadrilateral plate and
medially displaced quadrilateral plate can be fixed with the buttress plate which is
secured posteriorly along the sciatic buttress posterior to the joint and the
quadrilateral plate. On the other hand, the second window is not necessary in certain
acetabular fractures. MATERIALS AND METHODSBetween 2008 and 2009, 12
acetabular fractures were approached through modified Stoppa approach with or
without lateral window. There were 8 males and 4 females. The averaged age was
48.9 years. Fracture patterns were; Both Column(BC): 5, Anterior Column(AC): 3,
AC+posterior hemitranseverse: 2, Transverse: 2 cases. Complication, clinical and
radiographic results were evaluated.RESULTSTwo transient obturator nerve palsies
were diagnosed. One deep venous thrombosis was observed, but it was not life
threatning. Heterotopic ossification lymph edema, and infection were not observed.
Radiographic results were; Anatomical; 9, Imperfect: 3 cases. Clinical Results were;
Excellent: 6, Good: 3, Fair: 3 cases.CONCLUSIONModified Stoppa approach with or
without lateral window offers improved reduction and fixation possibilities compare
with Ilioinguinal approach. However, attention should be paid for obturator nerve
palsy during the exposure and reduction of quadrilateral plate.
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