Polytraumatized patient with two columns fracture of the acetabulum and skin abrasion, which incision to use with soft tissue: A case report at 15 years follow-up

Autor: M. Vimercati, D. Porreca, F. Pace, R. Spagnolo
Rok vydání: 2021
Předmět:
Zdroj: Journal of Orthopedics and Orthopedic Surgery. 2:9-13
ISSN: 2767-5130
DOI: 10.29245/2767-5130/2021/2.1133
Popis: Posterior fractures of the acetabulum are the most frequent pattern of acetabular fractures. Based on the works of Judet and Letournel, accurate reduction and stable osteosynthesis with early mobilization have become the gold standard for the treatment of posterior acetabular fractures. Recently, a less invasive approach has been described to decrease Kocher-Langenbeck (K-L) approach complications. The clinical case describes a patient affected by two-column fractures of the acetabulum with skin abrasions of the gluteus. The clinical evaluation was based on Merle d’Aubigne and Postel scoring, which Matta has modified. The approach used is a modified, less invasive K-L: a straight skin incision from the midpoint between the posterior superior iliac spine and the posterior tip of the greater trochanter. We observed the essential advantages using this approach were a lesser split of the gluteus maximus and no risk of damage for the superior gluteal nerve. In the early postoperative rehabilitation, we examined the strength of the gluteus maximus, which was better than in patients treated with the typical Kocher–Langenbeck approach. The patient resumed after fifteen years after surgery; hip mobility is complete and painless.
Databáze: OpenAIRE