Abstract:

Objective: The main purpose of the surgical treatment of posterior acetabular fracture is to achieve anatomical reduction to attain a functional and stable hip joint without pain. Although Kocher-Langenbeck (K-L) approach is the most commonly used surgical exposure, various modified approaches have been described in the literature. The aim of this study to determine the early surgical results of the acetabulum posterior fractures surgery via Iselin's modified K-L approach. Methods: We reviewed the hospital records of patients who were operated for acetabulum posterior wall fractures via Iselin's modified approach between 2016 and 2018. All patients had detailed radiological, clinical evaluation and fractures were classified by AO/ASIF classification. All patients had radiological and clinical evaluation at the end of the postoperative 1st year. Results: There were 16 men and 4 women with an average age of 42.8±18.0 (range 18-77) years. The average follow-up was 14.8±6.1 (range 6-28) months. The right hip was involved in 12 (60%) patients and the left in 8 (40%) patients. The average operative time was 78.6±16.7 (range, 54–115) minutes. Average blood loss during the operation was 179.22±51.9 (range, 100–260) ml. The postoperative reduction was graded as anatomic (0–1 mm of displacement) for 17 hips and imperfect (2–3 mm of displacement) for 3 patients. No patient had a deep infection, implant loosening, recurrent dislocation, deep venous thrombosis (DVT), pulmonary embolism (PE) or revision fixation. Conclusion: The modified approach of Iselin is a successful approach with its ease in the surgery of displaced fractures that extending proximally and early radiological and functional results.

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