Optimizing the Anatomic Reduction of Complex Acetabular Fractures: A Technical Enhancement to the Modified Stoppa Approach

Background: Choosing the proper approach to surgical treatment of various types of acetabular fractures can play an important role in minimizing adverse outcomes during and after surgery. In the present study, we described our experience on the outcome of Stoppa approach in anterior column acetabular fractures. Methods: This was a retrospective analysis of 40 patients with acetabular anterior column fractures that had undergone surgery with Stoppa approach. The study information, Harris Hip Score (HHS), and pre- and post-operative radiographic findings were collected by reviewing the hospital recorded files. Results: HHSs of 80 to 100 were achieved in 75.0% of patients. Completed (anatomic reduction less than 2 mm) displacement reduction was found in 97.5%. 2 mg/dl decreased serum level of hemoglobin (Hb) was found in 75.0%, leading to blood transfusion in 60% of subjects. Regarding post-procedural complications, the common event was infection in 15.0%, followed by degenerative joint disease (DJD) in 15.0%. The post-operative complications were similar in men and women, but were significantly higher in patientsolder than 50 years than the younger patients. Conclusion: Stoppa approach is associated with high success rate and the occurrence of rare and tolerable major complications.

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Modified Stoppa Approach: Beyond Acetabular Fractures

JBJS Case Connector ◽

10.2106/jbjs.cc.20.00333 ◽

2021 ◽

Vol 11 (2) ◽

Author(s):

Maroun Rizkallah ◽

Anais Bernardeau ◽

Peter Upex ◽

Pierre Emmanuel Moreau ◽

Hichem Abid ◽

...

Keyword(s):

Acetabular Fractures ◽

Stoppa Approach

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Modified Stoppa approach for operative treatment of acetabular fractures: 10-year experience and mid-term follow-up

Injury ◽

10.1016/j.injury.2018.03.031 ◽

2018 ◽

Vol 49 (6) ◽

pp. 1137-1140 ◽

Cited By ~ 7

Author(s):

Diederik O. Verbeek ◽

Kornelis J. Ponsen ◽

Mark van Heijl ◽

J. Carel Goslings

Keyword(s):

Operative Treatment ◽

Acetabular Fractures ◽

Stoppa Approach

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Short-term results of surgical treatment of acetabular fractures using the modified Stoppa approach

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2020.10.007 ◽

2020 ◽

Vol 11 (6) ◽

pp. 1121-1127

Author(s):

Tushar Nayak ◽

Samarth Mittal ◽

Vivek Trikha ◽

Kamran Farooque ◽

Shivanand Gamanagatti ◽

...

Keyword(s):

Surgical Treatment ◽

Acetabular Fractures ◽

Short Term ◽

Stoppa Approach

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Internal Fracture Fixation Using the Stoppa Approach in Pelvic Ring and Acetabular Fractures: Technical Aspects and Operative Results

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000219693.95873.24 ◽

2006 ◽

Vol 61 (3) ◽

pp. 662-667 ◽

Cited By ~ 59

Author(s):

Kees-Jan Ponsen ◽

Pieter Joosse ◽

Arvid Schigt ◽

Carel J. Goslings ◽

Jan S. K. Luitse

Keyword(s):

Fracture Fixation ◽

Pelvic Ring ◽

Acetabular Fractures ◽

Technical Aspects ◽

Operative Results ◽

Internal Fracture Fixation ◽

Stoppa Approach ◽

Internal Fracture

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Fixation of Pelvic-Acetabular Fractures Using a Midline-Modified Stoppa Approach: Clinical and Operative Outcomes

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.01.001 ◽

2018 ◽

Vol 24 (1) ◽

pp. 18-24

Author(s):

Kenneth Kin-yan Chan ◽

King-him Chui ◽

Ka-chun Ip ◽

Kin-bong Lee ◽

Wilson Li

Keyword(s):

Complication Rate ◽

Injury Severity ◽

Pelvic Ring ◽

Functional Results ◽

Bimodal Distribution ◽

Harris Hip Score ◽

Acetabular Fractures ◽

Pelvic Ring Fractures ◽

Stoppa Approach ◽

Polytrauma Patients

Background/Purpose This served as the first report from our locality to evaluate the modified Stoppa approach, via a low-midline wound, for treating pelvic–acetabular fractures. Methods A total of 17 polytrauma patients with pelvic and/or acetabular fractures were consecutively treated using the modified Stoppa approach. They were followed up for at least 1 year postoperatively for radiographic and clinical assessments, which included the Modified Merle d'Aubigne Score, Harris Hip Score, and pain visual analogue scale. Results Among the 17 patients, 11 had pelvic ring fractures, two had isolated acetabular fractures, and four had a combination of both. Excellent and anatomical reduction was achieved in 73.3% of pelvic fractures and 71.4% of acetabular fractures. Functional outcomes simulated a bimodal distribution. Age of patient and Injury Severity Score were significant predictors for functional results, whereas fracture characteristics and quality of reduction were not correlated with clinical outcomes in this series. We experienced a low complication rate. Conclusion Excellent exposure for fracture reduction and fixation with low complication rate was achieved with the modified Stoppa approach. We were encouraged by the results of this preliminary series for treating pelvic–acetabular fractures in polytrauma patients.

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The Anterior Intra-Pelvic (Modified Rives-Stoppa) Approach for Fixation of Acetabular Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0b013e3181dd0b84 ◽

2010 ◽

Vol 24 (5) ◽

pp. 263-270 ◽

Cited By ~ 123

Author(s):

H Claude Sagi ◽

Alan Afsari ◽

Daniel Dziadosz

Keyword(s):

Acetabular Fractures ◽

Stoppa Approach

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Advantages of Modified Stoppa Approach in Mangement of Acetabular Fractures

Benha Journal of Applied Sciences ◽

10.21608/bjas.2020.136666 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1-8

Author(s):

M.G. Al-Ashhab ◽

H.A. AL-Attar ◽

S.A. Shoulah ◽

M.S. Abd Elkareem

Keyword(s):

Acetabular Fractures ◽

Stoppa Approach

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Functional and radiological outcome in surgically managed posterior wall and column fractures of acetabulum

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214179 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1139

Author(s):

K. Nageswara Rao ◽

Ronak Dinesh Soni ◽

C. Nagesh ◽

P. A. Shravan Kumar ◽

B. Arvind Kumar

Keyword(s):

Functional Outcome ◽

Weight Bearing ◽

Posterior Wall ◽

Joint Surface ◽

Acetabular Fractures ◽

P Value ◽

Radiological Outcome ◽

Anatomic Reduction ◽

Joint Reduction

Background: The incidence of acetabular fractures has increased following road traffic accidents. The aim of the study is to evaluate functional and radiological outcome in surgically managed posterior wall and column fractures of acetabulum.Methods: This is a prospective study done at Nizam’s Institute of Medical Sciences, Hyderabad between May 2018 and May 2020. The sample size is 20 patients between the age group 18-60 years who presented to the hospital with closed posterior wall and/or column fractures of acetabulum with or without posterior dislocation of hip joint. Functional outcome is assessed by using the modified Merle D’ Aubigne Postel clinical grading system, radiological outcome by Matta et al and perioperative complication are assessed by retrospectively analyzing medical records and radiographics examination.Results: Functional outcome according to Merle D’ Aubigne and Postel score 16 patients (75%) showed good, 3 patients (20%) showed fair, 1 patient (5%) showed poor outcome. Radiological outcome according to Matta criteria, 16 patients (75%) showed excellent quality of joint reduction, 4 patients (25%) showed good quality of reduction of joint. There was significant correlation between anatomic reduction of the joint surface and functional outcome of the patient in our study (p value <0.05).Conclusions: Accurate joint reduction is of utmost importance in reduction of posterior wall or column fractures of acetabulum as posterior wall is the weight bearing zone. Functional outcome depends on fracture type, associated injuries, selection of patient, time between injury and surgery and postoperative rehabilitation.

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Fixation of Superomedially Displaced Acetabular Fractures Using an Anatomical Suprapectineal Quadrilateral Surface Plate Through Modified Stoppa Approach

10.21203/rs.3.rs-1214030/v1 ◽

2022 ◽

Author(s):

Dae-Kyung Kwak ◽

Seunghun Lee ◽

Yongmin Lee ◽

Ji-Hyo Hwang ◽

Je-Hyun Yoo

Keyword(s):

Surgical Outcomes ◽

Operation Time ◽

Acetabular Fractures ◽

3 Dimensional ◽

Vas Score ◽

Stoppa Approach ◽

Post Traumatic ◽

The Mean ◽

Traumatic Arthritis

Abstract Treatment of superomedially displaced acetabular fractures including a quadrilateral surface (QLS) is challenging. We present a surgical technique using an anatomical suprapectineal QLS plate through the modified Stoppa approach and report the availability of this plate to treat this fracture type along with the surgical outcomes. Thirteen consecutive patients (11 men and 2 women) who underwent surgical treatment using an anatomical suprapectineal QLS plate through a modified Stoppa approach for superomedially displaced acetabular fractures between June 2018 and June 2020, were enrolled retrospectively. These fractures included 10 both-column fractures and 3 anterior-column and posterior hemitransverse fractures, which were confirmed on preoperative 3-dimensional computed tomography. Surgical outcomes were clinically assessed using the Postel Merle d’Aubigné (PMA) score and visual analog scale (VAS) score at the final follow-up, and radiological evaluations were performed immediately after the operation and at the final follow-up. The follow-up period was longer than 1 year in all patients with a mean 22.9 months. The mean operation time was 103 min. Anatomical reduction was achieved in 11 (84.6%) patients, while imperfect reduction was achieved in the remaining two (15.3%) patients. At the final follow-up, radiographic grades were excellent, fair, and poor in 11 (84.6%), one (7.6%), and one patient, respectively. The mean PMA score was 16.3 (range, 13-18) and the mean VAS score was 1.0 (range, 0-3). No secondary reduction loss or implant loosening was observed. However, two patients underwent conversion to total hip arthroplasty due to post-traumatic arthritis and subsequent joint pain. No other complications were observed. Simultaneous reduction and fixation using an anatomical suprapectineal QLS plate through the modified Stoppa approach can provide satisfactory outcomes in superomedially displaced acetabular fractures, resulting in shorter operation times and fewer complications.

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