Modified Kocher-Langenbeck approach for the treatment of posterior wall or column acetabular fractures: The one-incision two-window method

( a ) Indicate the study’s design with a commonly used term in the title or the abstract ( b ) Provide in the abstract an informative and balanced summary of what was done and what was found Abstract Background: The Kocher-Langenbeck (K-L) approach is the standard method for the treatment of posterior wall or column acetabular fractures. This approach allows direct access to the posterior structures of the acetabulum, but is limited cranially and caudally by 5 the neurovascular bundle. The present study was conducted to assess the quality of 6 reduction and the incidence of complications in patients who underwent the modified 7 “one -incision two- window” K -L approach. Design: Retrospective case series. Patients/Participants: Thirteen consecutive patients from 2015 to 2017 who sustained an acute, displaced posterior wall or column acetabular fracture. Intervention: Open reduction and internal fixation through the modified “one -incision two- window” K -L approach. cases, according to Matta’s criteria. Concerning the incidence of complications, there were no iatrogenic neurovascular injury, no surgical site infections, and no osteonecrosis of the femoral head or heterotopic ossification in this cohort. One patient in group 1 experienced deep vein thrombosis in the lesion leg. Another two patients in group 2 developed posttraumatic osteoarthritis, with one diagnosed as Tonnis grade I lesion and the other as Tonnis grade III lesion. With respect to the clinical treatment outcome, the mean visual analogue scale (VAS), mean modified Harris Hip Score (mHHS) and subjective satisfaction rate were 1.7 (1.0-2.0), 90.6 (81-100), and 84.6% (80%-90%), respectively. Although there was no significant difference in the satisfaction rate (82.9% vs. 87.0%, P = 0.941) at 12 months after surgery, group 1 patients had more increased VAS score (2.0 vs. 1.2, P = 0.016) and more decreased mHHS (87.7 vs. 94.6, P = 0.014) than group 2 patients. Conclusions: Our pilot study -incision window” approach