A novel approach for posterior acetabular fractures: Surgical technique

Fuming Huang; Yuhui Chen; Tao Li; Han Liu; Qiguang Mai; Shicai Fan; Fuming Huang; Yuhui Chen; Tao Li; Han Liu; Qiguang Mai; Shicai Fan

doi:10.3934/mbe.2019400

Mathematical Biosciences and Engineering

2019, Volume 16, Issue 6: 7950-7962. doi: 10.3934/mbe.2019400

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Research article Special Issues

A novel approach for posterior acetabular fractures: Surgical technique

Department of Orthopaedics, The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Dadao West Street, Tianhe District, Guangzhou 510630, China.

Received: 17 April 2019 Accepted: 02 August 2019 Published: 29 August 2019

This article describes a novel approach, the Direct Posterior Approach (DPA) for the treatment of posterior acetabular fractures (posterior column, posterior wall, or both posterior column and wall). This technique allows direct visualization of the entire posterior wall, part of the hip capsule and the posterior column between the space of the gluteus medius and the piriformis superiorly. The approach spares the division of short external rotators, abductors, and hip capsule, thus preventing iatrogenic damage to the medial femoral circumflex artery, sciatic nerve, and superior and inferior gluteal neurovascular bundles, as well as protecting the vascularity of the fracture fragments. In addition to the low blood loss, short operative time and low risk of iatrogenic injury, patients who are treated by the DPA approach exhibit positive functional recovery in follow-up. DPA is an effective, safe and minimally-invasive technique for the treatment of posterior acetabular fractures.
- Direct Posterior Approach,
- acetabular fractures,
- surgical technique,
- posterior column,
- posterior wall
Citation: Fuming Huang, Yuhui Chen, Tao Li, Han Liu, Qiguang Mai, Shicai Fan. A novel approach for posterior acetabular fractures: Surgical technique[J]. Mathematical Biosciences and Engineering, 2019, 16(6): 7950-7962. doi: 10.3934/mbe.2019400

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Abstract

This article describes a novel approach, the Direct Posterior Approach (DPA) for the treatment of posterior acetabular fractures (posterior column, posterior wall, or both posterior column and wall). This technique allows direct visualization of the entire posterior wall, part of the hip capsule and the posterior column between the space of the gluteus medius and the piriformis superiorly. The approach spares the division of short external rotators, abductors, and hip capsule, thus preventing iatrogenic damage to the medial femoral circumflex artery, sciatic nerve, and superior and inferior gluteal neurovascular bundles, as well as protecting the vascularity of the fracture fragments. In addition to the low blood loss, short operative time and low risk of iatrogenic injury, patients who are treated by the DPA approach exhibit positive functional recovery in follow-up. DPA is an effective, safe and minimally-invasive technique for the treatment of posterior acetabular fractures.

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