Abstract
The appearance of acetabular fractures involving predominantly the anterior column has changed following an increase in elderly trauma. In elderly, a greater prevalence of quadrilateral plate fractures and acetabular dome impaction due to medial protrusion of the femoral head is noticed. The Pararectus approach provides distinct and safe surgical, intrapelvic, extraperitoneal access from anterior directly above the hip joint. The Pararectus approach combines the advantages of the ilioinguinal approach and Stoppa approach with access through the second window, however, without the need to dissect the inguinal canal (ilioinguinal approach) and without losing any direct access to the hip joint (Stoppa approach).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615–46.
Hirvensalo E, Lindahl J, Bostman O. A new approach to the internal fixation of unstable pelvic fractures. Clin Orthop Relat Res. 1993;297:28–32.
Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;305:112–23.
Ponsen KJ, Joosse P, Schigt A, Goslings JC, Luitse JS. Internal fracture fixation using the Stoppa approach in pelvic ring and acetabular fractures: technical aspects and operative results. J Trauma. 2006;61(3):662–7.
Jakob M, Droeser R, Zobrist R, Messmer P, Regazzoni P. A less invasive anterior intrapelvic approach for the treatment of acetabular fractures and pelvic ring injuries. J Trauma. 2006;60(6):1364–70.
Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified Rives-Stoppa) approach for fixation of acetabular fractures. J Orthop Trauma. 2010;24(5):263–70.
Andersen RC, O’Toole RV, Nascone JW, Sciadini MF, Frisch HM, Turen CW. Modified Stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma. 2010;24(5):271–8.
Laflamme GY, Hebert-Davies J, Rouleau D, Benoit B, Leduc S. Internal fixation of osteopenic acetabular fractures involving the quadrilateral plate. Injury. 2011;42(10):1130–4.
Khoury A, Weill Y, Mosheiff R. The Stoppa approach for acetabular fracture. Oper Orthop Traumatol. 2012;24(4–5):439–48.
Shazar N, Eshed I, Ackshota N, Hershkovich O, Khazanov A, Herman A. Comparison of acetabular fracture reduction quality by the ilioinguinal or the anterior intrapelvic (modified Rives-Stoppa) surgical approaches. J Orthop Trauma. 2014;28(6):313–9.
Isaacson MJ, Taylor BC, French BG, Poka A. Treatment of acetabulum fractures through the modified Stoppa approach: strategies and outcomes. Clin Orthop Relat Res. 2014;472:3345–52.
Bastian JD, Tannast M, Siebenrock KA, Keel MJ. Mid-term results in relation to age and analysis of predictive factors after fixation of acetabular fractures using the modified Stoppa approach. Injury. 2013;44(12):1793–8.
Ma K, Luan F, Wang X, et al. Randomized, controlled trial of the modified Stoppa versus the ilioinguinal approach for acetabular fractures. Orthopedics. 2013;36(10):e1307–e15.
Ferguson TA, Patel R, Bhandari M, Matta JM. Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 2010;92(2):250–7.
Anglen JO, Burd TA, Hendricks KJ, Harrison P. The “Gull sign”: a harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003;17(9):625–34.
Bastian JD, Giannoudis PV. Central acetabular fracture dislocations: are existing classifications comprehensive? Injury. 2014;45(12):1807–15.
Prasartritha T, Chaivanichsiri P. The study of broken quadrilateral surface in fractures of the acetabulum. Int Orthop. 2013;37(6):1127–34.
Keel MJ, Ecker TM, Cullmann JL, et al. The Pararectus approach for anterior intrapelvic management of acetabular fractures: an anatomical study and clinical evaluation. J Bone Joint Surg Br. 2012;94(3):405–11.
Bastian JD, Savic M, Cullmann JL, Zech WD, Djonov V, Keel MJ. Surgical exposures and options for instrumentation in acetabular fracture fixation: Pararectus approach versus the modified Stoppa. Injury. 2016;47:695.
Keel MJ, Tomagra S, Bonel HM, Siebenrock KA, Bastian JD. Clinical results of acetabular fracture management with the Pararectus approach. Injury. 2014;45(12):1900–7.
Mardian S, Schaser KD, Hinz P, Wittenberg S, Haas NP, Schwabe P. Fixation of acetabular fractures via the ilioinguinal versus Pararectus approach: a direct comparison. Bone Joint J. 2015;97-B(9):1271–8.
von Rüden C, Wenzel L, Becker J, Thannheier A, Augat P, Woltmann A, Bühren V, Perl M. The pararectus approach for internal fixation of acetabular fractures involving the anterior column: evaluating the functional outcome. International orthopaedics. 2018. https://doi.org/10.1007/s00264-018-4148-8
Keel MJB, Siebenrock KA, Tannast M, Bastian JD. The Pararectus approach: a new concept. JBJS Essent Surg Tech. 2018;8(3):e21.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bastian, J.D., Keel, M.J.B. (2019). The Pararectus Approach to the Acetabulum. In: Büchler, L., Keel, M. (eds) Fractures of the Hip. Fracture Management Joint by Joint. Springer, Cham. https://doi.org/10.1007/978-3-030-18838-2_6
Download citation
DOI: https://doi.org/10.1007/978-3-030-18838-2_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-18837-5
Online ISBN: 978-3-030-18838-2
eBook Packages: MedicineMedicine (R0)