Pararetus Approach For Treatment Of Delayed Acetabular Fractures

Object To study the clinical effect and relevant issues of pararetus approach for treatment of delayed acetabular fractures.Methods From December 2014 to June 2016,12 cases of deldayed acetabular fractures were surgically treated through pararectus approach.They were 8 males and 4 females,with an average age of 41.75 years(range,18 to 75).According to Judet-Letournel classification,1 case was simple fractures and 11 complicated ones.The duration from injury to surgery ranged 22-37days,averaging 27.9days.Merely anterior acetabular and pelvic fractures were treated with the pararetus approach only or joint ilioinguinal approach through small incision,in supine position.Ths cases involving the posterior acetabular wall and posterior column were managed with combined pararetus approach and posterior Kocher-Langenbeck approach,in the floating position.The titanium reconstruction plates and cannulated screws were applied in these cases.Results The operation time averaged179mins(110 to 235mins)and the intraoperative blood loss 1242ml(500 to 2600ml).The mean fellow-up period was 21.5months.According to Matta radiological evaluation postoperatively,reduction of acetabular fracture was rated as anatomic in 7cases,satisfactory in 3 and unsatisfactory in 2.The reset satisfaction rate was 83.3%.Injury to the lateral femoral cutaneous nerve occured in one case,traumatic arthritis occured in two cases.Clinical functional outcome were assessed by modified D’Aubigne and Postel clinical scoring.The excellent and good rate of functional outcome was 83.3%.Conclusion In principle,The pararetus approach can be on the delayed acetabular fracture were treated effectively,especially suitable for the complex fractures related to the quadrilateral plate by open reduction and internal fixation,which can obtain good clinical curative effect,is a feasible surgical approach for treatment of delayed acetabular fractures.