Clinical Results of Acetabular Fracture Fixation Using a Focal Kocher–Langenbeck Approach Without a Specialty Traction Table

Abstract

Objectives: 

To report the clinical result of a series of patients who underwent acetabular fracture fixation using a Kocher–Langenbeck approach without a specialty traction table.

Design: 

Retrospective case series.

Setting: 

Level 1 trauma center.

Patients/Participants: 

All patients who sustained posterior wall or posterior wall associated acetabular fractures that were treated operatively with a Kocher–Langenbeck approach over a 5-year period.

Intervention: 

Surgical fixation of acetabular fractures using a flat, radiolucent table.

Main Outcome Measurements: 

Outcomes included reduction quality and complications such as infection, heterotopic ossification, loss of reduction or fixation, medical complications, and neurologic injury.

Results: 

We identified 172 patients. No articular malreductions of greater than 2 mm were noted on postoperative CT scans. There were 13 surgical complications observed (8.1%). There was 1 death in our cohort (0.6%), and 3 patients had nonfatal pulmonary emboli (1.9%). There were no nerve injuries observed. There were 6 acute infections (3.1%) requiring surgical intervention. Three patients had symptomatic heterotopic bone that required excision (1.9%). Four patients (2.5%) required eventual total hip arthroplasty.

Conclusion: 

Overall, we report on the largest cohort in the literature undergoing a prone Kocher–Langenbeck without a specialty table for acetabular fracture fixation. We found that limited extremity prepping and draping for a prone Kocher–Langenbeck on a flat, radiolucent table did not result in an increased rate of postoperative neurological complications or malreductions of acetabular fractures.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.