Fatih İlker Can1, Rabia Mihriban Kılınç2, Emre Gültaç1, Cem Yalın Kılınç1, İsmail Gökhan Şahin1

1Department of Orthopedics and Traumatology, Muğla Sıtkı Koçman University Training and Research Hospital, Muğla, Türkiye
2Department of Radiology, Muğla Sıtkı Koçman University Training and Research Hospital, Muğla, Türkiye

Keywords: Anterior intrapelvic approach, bilateral acetabular fractures, functional outcomes, modified Stoppa approach, radiological outcomes.

Abstract

Objectives: This study aims to evaluate the two-year clinical results of bilateral acetabular fractures operated via a single incision with the modified Stoppa approach.

Patients and methods: Between January 2013 and January 2020, a total of 22 acetabular fractures of 11 patients (7 males, 4 females; mean age: was 42.9±13.7 years; range, 19 to 62 years) who were operated via the modified Stoppa approach were retrospectively analyzed. The medical records were analyzed in terms of time to surgery, fracture patterns, Injury Severity Score (ISS), operation duration, blood loss, reduction quality, perioperative complications and concomitant injuries. Reduction quality was assessed according to Matta’s criteria. The Harris Hip Score (HHS) and modified Merle d’Aubigne score (MDS) were utilized for functional assessment.

Results: The mean follow-up was 49±15 (range, 30 to 79) months. The mean ISS was 28.2±7.2. The mean modified MDS was 15.90±1.57. The mean HHS was 84.27±8.85. For both sides, reduction was anatomical-anatomical (63.6%) in seven patients, anatomical-imperfect in three (27.3%) patients, and imperfectpoor in one (9.1%) patient. According to the Kellgren-Lawrence radiological evaluation at 24 months of follow-up bilaterally, Grade 0-1 osteoarthritis was observed in six (54.5%) patients, Grade 1-1 in four (36.4%) patients, and Grade 1-2 osteoarthritis in one (9.1%) patient.

Conclusion: The modified Stoppa approach in bilateral acetabular fractures seems to be more preferable than other approaches, as it can be performed with a single incision and provides less bleeding, shorter operation duration, and satisfactory results.

Citation: Can Fİ, Kılınç RM, Gültaç E, Kılınç CY, Şahin İG. Fixation of bilateral acetabular fractures using the modified Stoppa approach: Two-year clinical outcomes. Jt Dis Relat Surg 2022;33(3):624-630.

Ethics Committee Approval

The study protocol was approved by the Muğla Sıtkı Koçman University Clinical Research Ethics Committee (date: 09.08.2018, no: 03). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Study design, writing: F.İ.C.; Radiological evaluation: R.M.K.; Statistical analysis: E.G.; Database compilation: C.Y.K.; Editing and revision: İ.G.Ş

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.