Results of Surgical Treatment of Acetabular Fractures Using Kocher-Langenbeck Approach

Aim of the study: To evaluate the results of acetabular fracturessurgically treated using posterior Kocher-Langenbeck approachfor internal fixation.Methods: A series of 42 consecutive cases treated during a 4year period was analysed. The mean age of the patients was 41years. According to the Letournel classification 9 posterior wallfractures, 3 posterior column fractures, 11 transverse fractures,4 posterior column and posterior wall fractures, 10 transverseand posterior wall fractures and 5 T-shaped fractures werenotedResults: Quality of reduction based on Matta's criteria showsanatomical reduction in 25 cases (59.5%), imperfect in 11 cases(26.2%) and poor in 6 cases (14.3%). Neurological injuryrepresented by peroneal nerve palsies occurred in 3 patients(7.1%). Acute infection was noted in one case (2.4%). Clinicalresults (for 38 patients) was excellent in 9 cases (23.7%), goodin 23 cases (60.5%), fair in 4 cases (10.5%) and poor in 2 cases(5.3%). There was a statistically significant correlation betweenquality of reduction and clinical results with r = 0.68 (Pearsoncoefficient). Heterotopic ossifications were recorded in 14 casesand osteonecrosis of the femoral head was recorded in 2 cases.Conclusions: Despite the relatively large number of complications,surgery treatment for acetabular fractures offers betterresults than conservative treatment, in which the complicationrate is much higher.

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