The Pararectus Approach in Acetabular Surgery: Radiological and Clinical Outcome.

"The authors report no conflict of interest."

"This retrospective analysis of prospectively collected data was conducted according to ICMJE guidelines and has been registered with the German Clinical Trials Register (ID: DRKS00011308). Table provides an overview of patients' data. All patients with acetabular fractures who underwent anterior surgical procedures through the pararectus approach and the ilioinguinal approach between January 2013 and December 2015 at a single Level 1 trauma center were included (n = 296). One-hundred ten patients were treated surgically using anterior pelvic approaches by 3 senior surgeons with experience of more than 20 years each in pelvic surgery. Patients were assigned to the pararectus approach group (P-group) or to the ilioinguinal approach group (I-group) based on surgeon's experience and decision. Because of fracture classification, the ideal approach to surgically manage the fracture was chosen. Only patients with complete follow-up data sets were included in this study. Finally, 61 patients (48 male and 13 female) with a median age of 55 (range 17–91) years were included. According to the chosen surgical approach, they were divided into 2 groups. The P-group included 43 patients, among them 32 male and 11 female patients with a median age of 55 (range 17–90) years. Eighteen patients [16 male, 2 female; median age: 53 (range 23–91) years] were treated through the ilioinguinal approach (I-group). This group included one patient who had received primary insufficient stabilization of the acetabular fracture elsewhere. General patients' demographic data including mechanism of injury, fracture classification, surgical details, and complications were evaluated. Acetabular fractures were classified according to the Judet and Letournel classification as well as to the OTA/AO pelvic classification., Complications were noted intraoperatively and postoperatively. The following surgical details were listed: time interval between trauma and surgical intervention, operation time, and fixation method. One year after surgery, all patients were evaluated in terms of a need for secondary THA according to post-traumatic joint arthritis. The study was not designed to investigate secondary THA in a subgroup analysis."