Outcome of Anterior Wall Acetabulum and Pelvis Fracture through a Modified Stoppa Approach: A Prospective Cohort Study

Abstract

Introduction: Acetabular fractures are becoming more common these days. The treatment of complicated acetabular fractures is challenging due to their location and associated injuries. Since the development of the Stoppa approach, it has been used as an alternative to the conventional ilioinguinal strategy. Aim: To assess the postoperative outcomes based on clinical and radiographic results in patients with fractures of the pelvis and acetabulum treated using the Modified Stoppa method. Materials and Methods: This prospective cohort study was conducted at Shri BM Patil Medical College, Hospital and Research Centre in Vijayapura, Karnataka, India, from January 2021 to May 2022. The study included 30 patients with acetabular fractures. Fracture reduction was achieved using a modified Stoppa technique. The patients were followed up for six months, and postoperative function was assessed using the Merle D’Aubigne Score and postoperative X-rays. Frequency distribution was used to analyse the frequency and percentage of study variables. The Chi-square test was used to determine the association between outcomes and radiographic results. Pearson’s correlation coefficient test was used to compare the follow-up time of the patients and the Merle D score. Results: Out of the 30 cases operated on using the modified Stoppa approach, 86.67% achieved anatomical reduction, with 53.33% showing a good outcome and 33.33% achieving an excellent outcome post-surgery. The results were subjected to statistical analysis. Frequency distribution was used to analyse the frequency and percentage of study variables. The Chi-square test was used to determine the association between outcomes and radiographic results. Pearson’s correlation coefficient test was used to compare the follow-up time of the patients and the Merle D score. There was a statistically significant correlation (r-value of 0.007) between the patient’s outcome and the radiographic results post-surgery. Conclusion: The use of less invasive techniques has simplified surgery and reduced complications in the treatment of difficult acetabular fractures. With improved surgical skills and early intervention, this innovative technique for anterior exposure of the acetabulum can be used effectively.

Keywords

• ilioinguinal approach
• merle d’aubigne hip score
• modified rives stoppa