Lateral rectus approach versus ilioinguinal approach for acetabular fractures: A retrospective comparative study

Abstract

Abstract Background The surgical management of acetabular fractures is challenging, and although new minimally invasive surgical approaches are being developed, the optimal surgical approach is still under discussion. We compared the clinical and radiographic findings of two surgical approaches for acetabular fractures: the lateral rectus approach (LRA) and the ilioinguinal approach (IA). Methods A consecutive cohort of 42 patients treated by a single surgeon using the LRA or IA from June 2015 to December 2018 with displaced acetabular fractures with a minimum 1-year clinical and radiographic follow-up were included. Clinical data were reviewed for fracture pattern, time to surgery, operative time, blood loss, quality of reduction, and perioperative complications. Fracture reduction quality was evaluated according to the Matta criteria. The Merle D’Aubigne-Postel and Harris Hip Score (HHS) were used for hip function outcomes. Results The complications, fracture reduction quality, Merle D’Aubigne-Postel score, and HHS were not significantly different between the approaches. There were statistically significant differences in the mean operative time (P = 0.003), intraoperative blood loss (P = 0.012), wound drainage (P = 0.031), and blood transfusion rate (P = 0.005) between the lateral rectus approach and the ilioinguinal approach. Conclusion Compared with the ilioinguinal approach, the lateral rectus approach is promising, especially for fractures in the quadrilateral area. The approach benefits fracture exposure, reduction, and fixation, thus shortening the operative time and reducing intraoperative bleeding. Trial registration Chinese Clinical Trial Registry, ChiCTR-2100043982, Registered on 6 March 2021 Level of Evidence: Level IV, retrospective comparative study.