Journal of orthopaedic trauma
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To quantify the reduction of acetabular fractures with displacement of the anterior and posterior column by using only a single anterior approach that combines the modified Stoppa approach with the lateral window of the classic ilioinguinal approach. The second objective was to evaluate the interobserver variability of our technique for radiographic evaluation of the reduction. ⋯ Anatomic or imperfect reduction of certain acetabular fractures involving displacement of both the anterior and posterior columns, even with significant (greater than 5 mm) displacement of the posterior column, can be obtained through the modified Stoppa window and the lateral window of the ilioinguinal approach. The method for evaluating preoperative displacement had excellent reliability.
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The purposes of this study were to evaluate the relationship between body mass index (BMI) and postoperative complications and to determine the incidence of reoperation after surgical treatment of pelvic ring injuries. ⋯ Body mass index correlates with an increased rate of complications and reoperation after operative treatment of pelvic ring injuries.
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To describe the clinical characteristics of combined injuries of the pelvis and acetabulum, which have not been previously described. We hypothesize that this combination of injuries affects not only the postinjury hemodynamics of the patient, but the outcome of subsequent acetabular fracture treatment. ⋯ Patients with combined pelvic and acetabular fractures represent a serious injury that includes the resuscitative challenges of pelvic injuries coupled with the difficulties of precise reduction of acetabular fractures. To obtain optimal reduction of the acetabulum, initial accurate reduction of the posterior pelvic lesion appears to be necessary.
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Intra-articular screw placement during acetabular surgery must be avoided. To date, no anatomic guidelines exist to prevent intra-articular screw placement in the treatment of complex acetabular fractures by the ilioinguinal or Stoppa approach. ⋯ This study identifies a safe zone for screw placement in the treatment of acetabular fractures when operated by an anterior approach. These findings have the potential to prevent further injury to the acetabular and femoral cartilage as a result of the surgical trauma and minimize intraoperative irradiation time.
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Report the technical aspects, radiographic results, and complications after minimum 1-year follow up of the anterior intra-pelvic (AIP or modified Rives-Stoppa) approach as an alternative to the ilioinguinal approach for the treatment of acetabular fractures. ⋯ Use of the AIP (modified Rives-Stoppa) approach for the treatment of acetabular fractures permits good to excellent reduction in the majority of cases while giving excellent visualization and access to the quadrilateral plate and posterior column. The AIP approach has a complication rate that is comparable to the ilioinguinal approach. We recommend the use of this technique as a potential alternative (but not replacement) to the classic ilioinguinal approach when anterior exposure of the acetabulum is required.