Extended iliofemoral versus triradiate approaches in management of associated acetabular fractures

Abstract

From July 1988 to June 1991, 110 complex acetabular fractures were operatively treated. A triradiate approach was used in 38 patients and an extended iliofemoral approach in 21. The mean patient age was 32 years (range, 15-80 years). These 59 patients were followed for a minimum of 36 months postoperatively. The postoperative function state was evaluated according to D'Aubigne/Postel, and the results were: Excellent, 32 patients (54%); Very Good, 10 (17%); Good, 5 (8%); Fair, 4 (7%); and Poor, 8 (14%). Adequacy of acetabular reconstruction was evaluated from the anteroposterior, obturator oblique, and iliac oblique radiographs. All patients had excellent or good radiographic results (< 2 mm step off or gap). Iatrogenic sciatic nerve injury was seen in two patients with the triradiate and one with the extended iliofemoral approach. Deep infection was seen in one patient in the extended iliofemoral group and two in the triradiate group. Eight patients developed heterotopic ossification of Brooker Grade III or IV despite prophylactic treatment with indomethacin. Both approaches provided good visualization of complex acetabular fractures.