Surgical Approaches for Acetabulum Fracture Treatment: Analytic Review

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Background. The use of classical and modified surgical approaches to acetabulum is accompanied by serious intra- and postoperative complications associated with tissues, vessels, nerves, and lymphatic structures injury. The choice of approach to acetabulum affects the surgical time and the blood loss volume.

The aim of the review was to compare the surgical time and blood loss volume using different surgical approaches to the acetabulum based on the relevant literature analysis.

Methods. The search was carried out in PubMed/MEDLINE and Scopus databases from 1964 to 2022. When conducting a search for the phrases acetabular fractures, surgical approach to the acetabulum, 4368 articles were found. As a result of the selection, 12 publications containing the most complete information on the studied indicators were included in the quantitative analysis.

Results. The data of surgical treatment of 540 patients with acetabulum fractures were analyzed. The average age of the patients was 45.2±11.6 years. Among the causes of pelvic and acetabulum fractures, road accident (70.4%) and falls from height (21.3%) largely prevailed. The blood loss depended on the use of specific approaches or their combination, and the surgical time. The shortest surgical time (101.0±27.0 min.) was required using pararectal approach, the longest (264±56.4 min.) — with the use of ilio-inguinal approach. The largest volume of blood loss was observed with Pfannenstiel approach — 1057.1±377.9 ml. No statistically significant differences were found when comparing the Kocher-Langenbeck (793±328 ml), ilio-inguinal (828±64 ml) and pararectal (798±322 ml) approach. Performing the Kocher-Langenbeck approach in the patient’s lateral position reduces the surgical time by 16.8% and reduces blood loss by 12.4% compared to the patient’s prone position.

Conclusion. Comparative clinical studies are required to determine the safest surgical approaches to the acetabulum, depending on the type of fracture, the mechanism of injury and the age of the patient.

作者简介

Alexandr Kolesnik

Cytoproject LLC

编辑信件的主要联系方式.
Email: ko-lesnik@mail.ru
ORCID iD: 0000-0003-1435-8743

Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Sergey Donchenko

Botkin City Clinical Hospital

Email: Don_03@mail.ru
ORCID iD: 0000-0003-3341-7446

Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Vladislav Surikov

Botkin City Clinical Hospital; Russian Medical Academy of Continuing Postgraduate Education

Email: Airbag366@yandex.ru
ORCID iD: 0000-0003-3668-2376
俄罗斯联邦, Moscow; Moscow

Dmitry Ivanov

Lytkarino City Hospital

Email: Ivanovda2001@mail.ru
ORCID iD: 0000-0002-5821-6774
俄罗斯联邦, Lytkarino

Evgeniy Tarasov

Odintsovo City Hospital

Email: t.john@mail.ru
ORCID iD: 0000-0002-3960-0148
俄罗斯联邦, Odintsovo

Dmitry Yarmamedov

Kursk State Medical University

Email: D-yarmamedov@mail.ru
ORCID iD: 0000-0002-4580-5502
俄罗斯联邦, Kursk

Ivan Solodilov

Kursk City Clinical Hospital No. 4

Email: Ivan_s_007@mail.ru
ORCID iD: 0000-0001-8219-5582

Cand. Sci. (Med.)

俄罗斯联邦, Kursk

参考

  1. Borg T., Hernefalk B., Hailer N.P. Acute total hip arthroplasty combined with internal fixation for displaced acetabular fractures in the elderly: a short-term comparison with internal fixation alone after a minimum of two years. Bone Joint J. 2019;101-B(4):478-483. doi: 10.1302/0301-620X.101B4.BJJ-2018-1027.R2.
  2. Sardesai N.R., Miller M.A., Jauregui J.J., Griffith C.K., Henn R.F., Nascone J.W. Operative management of acetabulum fractures in the obese patient: challenges and solutions. Orthop Res Rev. 2017;9:75-81. doi: 10.2147/ORR.S113424.
  3. Butterwick D., Papp S., Gofton W., Liew A., Beaulé P.E. Acetabular fractures in the elderly: evaluation and management. J Bone Joint Surg Am. 2015;97(9):758-768. doi: 10.2106/JBJS.N.01037.
  4. Hoge S., Chauvin B.J. Acetabular Fractures. [Updated 2022 Mar 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544315/.
  5. Rommens P.M., Bastian J.D. Focus on acetabular fractures. Eur J Trauma Emerg Surg. 2021;47(5):1289-1290. doi: 10.1007/s00068-021-01766-1.
  6. Mohan K., Broderick J.M., Raza H., O’Daly B., Leonard M. Acetabular fractures in the elderly: modern challenges and the role of conservative management. Ir J Med Sci. 2022;191(3):1223-1228. doi: 10.1007/s11845-021-02711-2.
  7. Borrelli J.Jr., Anglen J.O. Acute Total Hip Arthroplasty for Fracture of the Acetabulum. In: Arthroplasty for the Treatment of Fractures in the Older Patient. Springer Nature; 2018. p. 129-144.
  8. Cornell C.N. Management of acetabular fractures in the elderly patient. HSS J. 2005;1(1):25-30. doi: 10.1007/s11420-005-0101-7.
  9. Russell G.V. Jr., Nork S.E., Chip Routt M.L. Jr. Perioperative complications associated with operative treatment of acetabular fractures. J Trauma. 2001;51(6):1098-1103. doi: 10.1097/00005373-200112000-00014.
  10. Manson T.T. Open Reduction and Internal Fixation Plus Total Hip Arthroplasty for the Acute Treatment of Older Patients with Acetabular Fracture: Surgical Techniques. Orthop Clin North Am. 2020;51(1):13-26. doi: 10.1016/j.ocl.2019.08.006.
  11. Harris A.M., Althausen P., Kellam J.F., Bosse M.J. Simultaneous anterior and posterior approaches for complex acetabular fractures. J Orthop Trauma. 2008;22(7):494-497. doi: 10.1097/BOT.0b013e3181830d2a.
  12. Wu H., Shang R., Cai X., Liu X., Song C., Chen Y. Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-Screw System. Orthop Surg. 2020;12(2):488-497. doi: 10.1111/os.12648.
  13. Swartman B., Pelzer J., Vetter S.Y., Beisemann N., Schnetzke M, Keil H. et al. Minimally invasive surgical treatment of minimally displaced acetabular fractures does not improve pain, mobility or quality of life compared to conservative treatment: a matched-pair analysis of 50 patients. J Orthop Surg Res. 2020;15(1):115. doi: 10.1186/s13018-020-01611-y.
  14. Goyal T., Singh G., Kumar Tripathy S., Schuh A., Veerappa L.A., Kumar Sen R. Acetabulum fractures in elderly: A systematic review of fracture pattern and treatment. J Clin Orthop Trauma. 2020;11(6):989-1001. doi: 10.1016/j.jcot.2020.09.008.
  15. Wollmerstädt J., Pieroh P., Schneider I., Zeidler S., Höch A., Josten C. et al. Mortality, complications and long-term functional outcome in elderly patients with fragility fractures of the acetabulum. BMC Geriatr. 2020;20(1):66. doi: 10.1186/s12877-020-1471-x.
  16. Xue Z., Qin H., Ding H., An Z. A Novel Approach for Treatment of Acetabular Fractures. Med Sci Monit. 2016;22:3680-3688. doi: 10.12659/msm.898887.
  17. Khira Y.M., El-Aidy S. Surgical treatment of marginal osteochondral impaction in acetabular fractures. Musculoskelet Surg. 2018;102(2):139-145. doi: 10.1007/s12306-017-0506-8.
  18. Li Y.T., Hung C.C., Chou Y.C., Chen J.E., Wu C.C., Shen H.C. et al. Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques. Biomed Res Int. 2019;2019:3971571. doi: 10.1155/2019/3971571.
  19. Lont T., Nieminen J., Reito A., Pakarinen T.K., Pajamäki I., Eskelinen A. et al. Total hip arthroplasty, combined with a reinforcement ring and posterior column plating for acetabular fractures in elderly patients: good outcome in 34 patients. Acta Orthop. 2019;90(3):275-280. doi: 10.1080/17453674.2019.1597325.
  20. Kashyap S., Mahajan S., Lal M. Effects of topical tranexamic acid during open reduction and internal fixation of acetabular fractures: A retrospective study. Acta Orthop Traumatol Turc. 2019;53(3):175-179. doi: 10.1016/j.aott.2019.03.006.
  21. Salameh M., Hammad M., Babikir E., Ahmed A.F., George B., Alhaneedi G. The role of patient positioning on the outcome of acetabular fractures fixation through the Kocher-Langenbeck approach. Eur J Orthop Surg Traumatol. 2021;31(3):503-509. doi: 10.1007/s00590-020-02793-1.
  22. Wang C., Chen Y., Wang L., Wang D., Gu C., Lin X. et al. Three-dimensional printing of patient-specific plates for the treatment of acetabular fractures involving quadrilateral plate disruption. BMC Musculoskelet Disord. 2020;21(1):451. doi: 10.1186/s12891-020-03370-7.
  23. Wang P., Kandemir U., Zhang B., Fei C., Zhuang Y., Zhang K. The effect of new preoperative preparation method compared to conventional method in complex acetabular fractures: minimum 2-year follow-up. Arch Orthop Trauma Surg. 2021;141(2):215-222. doi: 10.1007/s00402-020-03472-w.
  24. Yang Y., Zou C., Fang Y. The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures. J Orthop Surg Res. 2020;15(1):588. doi: 10.1186/s13018-020-02133-3.
  25. Öztürk A.M., Süer O., Şirintürk S., Aktuğlu K., Govsa F., Özer M.A. A retrospective comparison of the conventional versus three-dimensional printed model-assisted surgery in the treatment of acetabular fractures. Acta Orthop Traumatol Turc. 2020;54(4):385-393. doi: 10.5152/j.aott.2020.19054.
  26. Giannoudis P.V., Grotz M.R., Papakostidis C., Dinopoulos H. Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br. 2005;87(1):2-9.
  27. Ferguson T.A., Patel R., Bhandari M., Matta J.M. Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 2010;92(2):250-257. doi: 10.1302/0301-620X.92B2.22488.
  28. Kim C.Y., Trivedi N.N., Sivasundaram L., Ochenjele G., Liu R., Vallier H. Predicting postoperative complications and mortality after acetabular surgery in the elderly: a comparison of risk stratification models. Current Orthop Practice. 2020;31(2):162-167. doi: 10.1097/BCO.0000000000000836.
  29. Hasegawa I., Hasegawa M., Livingstone J.P., Kane T.J.K. 4th., Lee L. What’s New in Geriatric Acetabular Fractures. Hawaii J Health Soc Welf. 2022;81(3 Suppl 1):19-24.
  30. Rajagopal H.P., Mohan M.M., Kurian B.T., Ramesh L.J., Pilar A., Tamboowalla K.B. Functional outcome following conservative management of acetabular fractures. Int J Res Orthop. 2020;6(5):1027-1031. doi: 10.18203/issn.2455-4510.IntJResOrthop20203726.
  31. Baker G., McMahon S.E., Warnock M., Johnston A., Cusick L.A. Outcomes of conservatively managed complex acetabular fractures in the frail and elderly one year post injury. Injury. 2020;51(2):347-351. doi: 10.1016/j.injury.2019.12.008.
  32. Deren M.E., Babu J., Cohen E.M., Machan J., Born C.T., Hayda R. Increased Mortality in Elderly Patients with Sarcopenia and Acetabular Fractures. J Bone Joint Surg Am. 2017;99(3):200-206. doi: 10.2106/JBJS.16.00734.
  33. Judet R., Judet J., Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-1646.
  34. Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res. 1980;(151):81-106.
  35. Butler B.A., Lawton C.D., Hashmi S.Z., Stover M.D. The Relevance of the Judet and Letournel Acetabular Fracture Classification System in the Modern Era: A Review. J Orthop Trauma. 2019;33 Suppl 2:S3-S7. doi: 10.1097/BOT.0000000000001401.
  36. Bible J.E., Wegner A., McClure D.J., Kadakia R.J., Richards J.E., Bauer J.M. et al. One-year mortality after acetabular fractures in elderly patients presenting to a level-1 trauma center. J Orthop Trauma. 2014;28(3):154-159. doi: 10.1097/BOT.0b013e31829e801b.
  37. Herath S.C., Pott H., Rollmann M.F.R., Braun B.J., Holstein J.H., Höch A. et al. Geriatric Acetabular Surgery: Letournel’s Contraindications Then and Now-Data From the German Pelvic Registry. J Orthop Trauma. 2019;33 Suppl 2:S8-S13. doi: 10.1097/BOT.0000000000001406.
  38. Mauffrey C., Hao J., Cuellar D.O. 3rd., Herbert B., Chen X., Liu B. et al. The epidemiology and injury patterns of acetabular fractures: are the USA and China comparable? Clin Orthop Relat Res. 2014;472(11):3332-3337. doi: 10.1007/s11999-014-3462-8.
  39. Cavalcante M.C., de Arruda F.A.A., Boni G., Sanchez G.T., Balbachevsky D., Dos Reis F.B. Demographic analysis of acetabular fractures treated in a quaternary care hospital from 2005 to 2016. Acta Ortop Bras. 2019;27(6):317-320. doi: 10.1590/1413-785220192706207042.
  40. Letournel E., Judet R. Fractures of the Acetabulum. Berlin, Germany: Springer-Verlag; 1993. p. 375-385; 521-540; 591-633.
  41. Shazar N., Eshed I., Ackshota N., Hershkovich O., Khazanov A., Herman A. Comparison of acetabular fracture reduction quality by the ilioinguinal or the anterior intrapelvic (modified Rives-Stoppa) surgical approaches. J Orthop Trauma. 2014;28(6):313-319. doi: 10.1097/01.bot.0000435627.56658.53.
  42. Negrin L.L., Seligson D. Results of 167 consecutive cases of acetabular fractures using the Kocher-Langenbeck approach: a case series. J Orthop Surg Res. 2017;12(1):66. doi: 10.1186/s13018-017-0563-6.
  43. Matta J.M. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res. 1994;(305):10-19.
  44. Matta J.M. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1996;78(11):1632-1645.
  45. Kloen P., Siebenrock K.A., Ganz R. Modification of the ilioinguinal approach. J Orthop Trauma. 2002;16(8):586-593. doi: 10.1097/00005131-200209000-00008.
  46. Cole J.D., Bolhofner B.R. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;(305):112-123.
  47. Gao Y.S., Zhou Z.B., Tang M.J., Yu X.W., Chen S., Zhang C.Q. et al. Late surgery for acetabular fractures in a Chinese level I trauma centre: surgical experience and outcomes. Int Orthop. 2015;39(9):1865-1871. doi: 10.1007/s00264-015-2932-2.
  48. Rickman M., Young J., Bircher M., Pearce R., Hamilton M. The management of complex acetabular fractures in the elderly with fracture fixation and primary total hip replacement. Eur J Trauma Emerg Surg. 2012;38(5):511-516. doi: 10.1007/s00068-012-0231-9.
  49. Yang Y., Li Q., Cui H., Hao Z., Wang Y., Liu J. et al. Modified Ilioinguinal Approach to Treat Pelvic or Acetabular Fractures: A Retrospective Study. Medicine (Baltimore). 2015;94(37):e1491. doi: 10.1097/MD.0000000000001491.
  50. Jakob M., Droeser R., Zobrist R., Messmer P., Regazzoni P. A less invasive anterior intrapelvic approach for the treatment of acetabular fractures and pelvic ring injuries. J Trauma. 2006;60(6):1364-1370. doi: 10.1097/01.ta.0000208139.97474.f7.
  51. Andersen R.C., O’Toole R.V., Nascone J.W., Sciadini M.F., Frisch H.M., Turen C.W. Modified Stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma. 2010;24(5):271-278. doi: 10.1097/BOT.0b013e3181b2b4ca.

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2. Fig. 1. The choice of approach to acetabulum depending on the mechanism of injury.

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3. Fig. 2. Classification of acetabulum fractures according to Judet-Letournel in the cited sources. Percentages indicate the proportion of acetabulum fractures types from their total number

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4. Fig. 3. Operative time, blood loss and the age of patients with various surgical approaches to the acetabulum

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5. Fig. 4. Operative time, blood loss and the age of the patients during the surgery using the Kocher-Langenbeck approach in the supine position and lateral position

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6. Fig. 5. Operative time, blood loss and the age of patients during surgery through the classical iliac-inguinal approach and iliac-inguinal approach in the Stoppa modification

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