Obada B., Serban Al., Anderlik St., Badauta M., Costea D., Grasa C.

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Obada B., Serban Al., Anderlik St., Badauta M., Costea D., Grasa C. P217 Our experience with modified Stoppa approach for surgical treatment of acetabular fractures Obada B., Serban Al., Anderlik St., Badauta M., Costea D., Grasa C. Emergency Clinical Hospital of Constanta, Romania AIM The aim of the paper was to analyse the degree of cominution of the acetabular fractures, the clinical and radiological results, early and late complications after a two year follow-up of modified Stoppa approach for the treatment of acetabular fractures. We tried to evaluate the results and the efficacy of this operative technique. MATERIAL. METHODS. We evaluated 19 patients with acetabular fractures who were subjected to osteosynthesis with plate and screws using modified Stoppa approach, hospitalised in our hospital between January 2012 and December 2015. All the patients needed surgery via anterior approach for the stabilisation of acetabular fractures. The criteria we analysed were: fracture type, surgical time, blood loss during operation, quality of reduction, degree of comminution in the acetabular weight-bearing area, early and late postoperative complications. RESULTS The results were evaluated retrospectively analyzing the medical records of the patients. The follow-up radiographs were graded according to the criteria developped by Matta and functional outcome was assessed using Harris hip score. Mean follow-up was 16.2 months. Mean perioperative bleeding was 960cc (range 800-1250 cc). Mean Harris hip score was 77.8. Anatomical reduction of the acetabular fractures was achieved in 14 patients, satisfactory in 3 patients and poor in 2 cases. Postoperative foot drope was observed in 2 patients, obturator nerve damage in 1 patient, partial iliac vein damage 1 case and avascular necrosis of the femoral head 1 case. CONCLUSIONS The modified Stoppa approach is a good alternaive to the ilioinguinal approach and it can be used to treat complex acetabular fractures who need an anterior approach. Comminution of the acetabular fractures is an important factor causing non-anatomic reduction and finally unsatisfactory clinical results.