Is it possible that most of the displaced acetabular fractures can be managed through a single ilioinguinal approach? 2–7 Years experience results

This is a prospective study on the medium and long-term results of the operative treatment of 54 patients with displaced acetabular fractures of different types in a 7 years period. All patients were operated through a single ordinary ilioinguinal approach. The patients were followed for an average of 60 months (range 24–84 months). The postoperative reduction was anatomical in 42.6%; satisfactory in 44.4%; and unsatisfactory in 13% of the cases with the mean of 13 mm residual gapping. The radiological results were excellent in 37%; good in 46.3%; fair in 11.1%; and poor in 5.6% of the cases. Clinically, 24.1% of the cases had excellent scores, 59.2% had good scores, 9.3% had fair scores, and 7.4% had poor scores. Al unsatisfactory clinical results were related to the ipsilateral posttraumatic hip arthritis. There was a strong correlation between the preoperative fracture displacement and: the postoperative residual displacement (P = 0.008); the clinical results (P = 0.001); and the radiological results (P = 0.001). Complications occurred intraoperatively in 13%, early postoperatively in 22.2%, and lately in 24.1% of the cases. No awkward neurovascular injuries or cumbersome heterotopic ossification were encountered in any case. The results show that the spring plate is a good adjunct for posterior column and quadrilateral surface screws fixation, also that the single ilioinguinal approach can address most of the displaced acetabular fractures involving the weight bearing dome with the least possible complications and morbidity.