Posterior acetabular wall fixation through quadrilateral surface in patients treated with anterior pelvic approach

Aim of the study was to evaluate the clinical and radiological results of the patients who has associated acetabular fractures with posterior wall involvement and posterior wall treated with lag screw through quadrilateral surface via anterior pelvic approach (Modified Stoppa). Between January 2014 and March 2019, 12 patients who has more than 12 months follow up had included to study. As control group 14 patients operated with anterior pelvic approach combined with posterior approach and posterior wall fixated with plate and screws and had more than 12 months follow up had included. Patients x-ray views and computed tomography (CT) images have been assessed before and after the operation. Judet-Letournel classification was used for fracture classification, Matta's criterias was used for reduction quality and functional outcomes Merle D'Aubigné and Postel score and Harris Hip Score was used. According to Judet-Letournel fractures were 46,1% both column, 23% transverse and posterior wall, 19,2% T-type, 11,5% anterior column and posterior hemitransverse. As Matta reduction criteria, in lag screw group 83,3% of patients has excellent-good, in plate group 85,7% of patients has excellent-good results were calculated. As Merle D'Aubigné and Postel scores, 83,3% of patients had excellent-good in the lag screw group and 78,5% of patients had excellent-good results in the plate group. Harris hip scores showed 74,9% of patients had excellent-good in lag screw group and 71,4% of patients had excellent-good results in plate group. Operation time median was respectively 107,5 min. (90-225) and 127,5 min. (100-160) for lag screw and plate groups. Blood loss median value was 425 mL (250-2300) in lag screw group and 680 mL (400-1300) in the plate group. There was no statistically significant difference between reduction quality or clinical and functional scores however operation time and blood loss in plate group were increased compared with the lag screw group, there was a statistically significant difference. This study shows that in appropriate patients, posterior wall fixation with lag screw through quadrilateral surface via anterior pelvic approach is adequate and practical surgical technique and requires no necessity of posterior approach.