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Review Question - QID 3141

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QID 3141 (Type "3141" in App Search)
A 55-year-old male involved in a motor vehicle collision sustains an acetabular fracture. Which of the following approaches would provide the best exposure for open reduction internal fixation of the displaced fragments seen on the 3-D CT image in Figure A?
  • A

Modified Stoppa approach

54%

2286/4236

Extended Iliofemoral

16%

670/4236

Kocher-Langenbeck

13%

556/4236

Medial window of the ilioinguinal

11%

480/4236

Simultaneous anterior and posterior exposure

5%

226/4236

  • A

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Figure A represents an acetabular fracture pattern with medial displacement of the quadrilateral plate. Limited bone stock and anatomic access create a surgical challenge to treat these fractures. Both an ilioinguinal and modified Stoppa approach allow access to this area. However, use of the Stoppa approach often allows the middle window of the ilioinguinal approach to be avoided, resulting in minimal dissection of the inguinal canal, femoral nerve, and external iliac vessels.

Cole et al discuss their initial experience using the modified Stoppa approach for fixation of acetabular fractures. Of the 55 fractures treated, 89 % of the post operative radiographs had either an excellent or good rating.

Qureshi et al discuss their technique for infrapectineal plating that allows for stable fixation by resisting medial displacement through the quadrilateral surface.

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