The Kocher-Langenbeck Approach: Differences in Outcome of Transverse Acetabular Fractures Depending on the Patient's Position

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Lukas Leopold Negrin, David Seligson

Abstract

The Kocher-Langenbeck approach is most frequently used for open reduction and internal fixation of transverse acetabular fractures, the positioning of the patient still falling to the preference of the surgeon. The impact of 'prone' and 'lateral' positioning on radiographic outcome and postoperative complication rates was evaluated by this retrospective study. Between 2002 and 2007, 27 consecutive cases of transverse acetabular fractures were treated randomly by four attending surgeons at a Level I trauma center, 18 done in a lateral and nine in a prone position, with no significant difference in age and pre- and intraoperative parameters; no patients were excluded. The complication rate was analyzed by medical records. After an average of 9 months postoperatively, the radiographic outcome was evaluated by plain X-rays and computed tomography (CT) scans using the Matta system, the Epstein classification, and the Brooker grades. Post-traumatic arthrosis and avascular necrosis of the femoral head were documented. We found a significantly poorer quality of fracture reduction (p = 0.032) and higher rate of posttraumatic arthrosis (p = 0.049) for patients who were operated for transverse acetabular fracture in the lateral versus the...Continue Reading

References

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Dec 18, 2009·The Journal of Trauma·Lukas Leopold NegrinDavid Seligson

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Citations

Mar 29, 2014·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·R PascarellaR Fantasia
Apr 28, 2017·Journal of Orthopaedic Surgery and Research·Lukas L Negrin, David Seligson
Sep 21, 2018·JBJS Essential Surgical Techniques·Theodoros H TosounidisPeter V Giannoudis
Jul 14, 2020·Journal of Orthopaedic Trauma·Kevin D PhelpsJoseph R Hsu

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