Pararectus-approach vs. Stoppa-approach for the treatment of acetabular fractures - a comparison of clinical and operative outcome parameters

Objectives Fractures of the acetabulum are rare injuries. The indication for surgical stabilization depends on the grade of instability and dislocation. The Pararectus-approach has been introduced a few years ago as an alternative anterior approach in acetabular surgery. Aim of this registry study was to compare the Pararectus-approach and the modified Stoppa approach regarding complications and quality of reduction.

Methods We retrospectively analyzed all patients from the prospective consecutive multicenter German Pelvic Registry of the German Trauma Society. Patients with an operatively treated acetabular fracture using either the Pararectus-approach or the Stoppa-approach were included and divided into two groups. Demographic, clinical and operative parameters were recorded and compared for the two groups.

Results and Conclusion Between January 2003 and December 2017, 384 patients with an acetabular fracture were operated using either the Pararectus-approach (n = 120) or the Stoppa-approach (n = 264). There were no differences between the two groups regarding demographic parameters. The overall complication rate was 23.7% (91/384) and the overall mortality rate was 3.6% (14/384) with no difference between the two groups respectively. The quality of reduction and the osteosynthesis-associated complication rate was equal in both groups. However, operation time was significantly longer in the Pararectus group (255±125 vs. 205±103 minutes; p < 0.001).

Despite a longer operation time, the Pararectus-approach is equivalent to the Stoppa-approach for the treatment of acetabular fractures regarding complication rates and quality of reduction.

Stichwörter acetabular fracture, Hip joint, pelvis, pelvic fracture, surgical site infection, neurovascular injury, anterior pelvic approaches

Publication History

Article published online:
15 October 2020