The pararectus approach for internal fixation of acetabular fractures involving the anterior column: evaluating the functional outcome

IntroductionAim of this retrospective analysis of prospectively collected data was to evaluate the functional mid-term outcome twoyears after open reduction and internal fixation of acetabular fractures involving the anterior column with affection of the quadrilateral plate using the pararectus approach on a large cohort.MethodFifty-two patients (12 female, 40 male) with a median age of 55 (range 18-90) years and displaced acetabular fractures involving the anterior column were surgically treated in a single level I trauma centre between July 2012 and February 2016 using the pararectus approach. Thirty-four patients (8 female and 26 male) with a median age of 58 (range 20-85)years were available for complete clinical follow-up at regular intervals, finally 24months post-operatively. Functional outcome was evaluated according to modified Merle d'Aubigne score, Lower Extremity Functional Scale, WOMAC, and SF-36.ResultsRange of time between trauma and surgical treatment was three (range 0-19) days. Operation time was 140 (range 60-240) minutes, and duration of hospital treatment was 19 (range 7-38) days. Functional results in 34 patients available for final follow-up demonstrated 68 points (median; range 39-80) according to the Lower Extremity Functional Scale, 6% according to the WOMAC (mean; SD14.5%), and 69% (mean; SD +/- 20.1%) according to the SF-36. The modified Merle d'Aubigne score was excellent in 22 patients, good in eight patients, and fair in four patients.Discussion/conclusionp id=Par4Based on the good to excellent functional mid-term follow-up results of this study, the pararectus approach can be recommended as sufficient alternative single access to address displaced acetabular fractures involving the anterior column, independent of patients' age.