Objective: To compare different surgical approaches in order to obtain better surgical exposure and more reliable reset fixation according to the different types of quadrilateral area fractures of acetabular.
Methods: From January 2006 to January 2011, 58 patients with the quadrilateral area fractures of acetabular were treated by surgical operation through the simple Kocher-Langenbeck (KL) approach, ilioinguinal approach, modified Stoppa approach, or combined surgical approach, or a combination of anterior column screw fixation percutaneously and modify Stoppa approach.
Results: Forty-nine patients were followed up for an average time of 32 months ranging from 2 to 6 years. One patient with deep infection cured after treatment of effective antibiotics and drainage, 2 patients had a sciatic nerve injury, 2 cases of avascular necrosis of the femoral head. Among them, 36 cases were anatomical reducted, 8 were good and 5 were poor according to Matta's radiographic assessment system. According to the mean Merle d'Aubigne and Postel Score,32 patients got excellent result, 12 good,4 fair and 1 bad,the average score was (15.3 +/- 2.5).
Conclusion: Single classic surgical approach can only use for some types of the complex quadrilateral area fractures of acetabular while combination approach may need for some fractures. Modified Stoppa approach combined with ilioinguinal approach or a combination of anterior column acetabular screw fixation are the most effective surgical approaches for complex quadrilateral area fractures of acetabular.
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