TY - JOUR
T1 - The Pararectus approach
T2 - a preferred surgical approach for fixation of acetabular fractures predominantly involving the anterior column - a narrative review
AU - Freude, Thomas
AU - Krappinger, Dietmar
AU - Lindtner, Richard A.
AU - Stuby, Fabian
N1 - Freude: Department of Orthopaedics and Traumatology, Paracelsus
Medical University Salzburg, Salzburg, Austria;
Lehr-KH: Department of Traumatology and General Surgery, BG
Unfallklinik Murnau, Murnau Am Staffelsee, Germany
PY - 2024/7/30
Y1 - 2024/7/30
N2 - Beginning in France in the 1960s, the management of acetabular fractures has increasingly evolved toward surgical treatment strategies. The basic principles established by the pioneers of acetabular surgery, Letournel and Judet - anatomical reconstruction of the joint and stable osteosynthesis - remain unchanged. Modern advancements in surgical techniques aim to reduce access-related trauma and minimize complications. The notable rise in acetabular fractures among the elderly, which predominantly affect the anterior aspects of the acetabulum, has driven the development of less invasive, soft tissue-sparing anterior approaches. This evolution began with the ilio-inguinal approach in the 1960s, progressed to the modified Stoppa approach in the 2000s and, most recently, the Pararectus approach in the 2010s. Each of these approaches upholds the fundamental principles of effective acetabular fracture care, while offering distinct advantages and disadvantages. In this review, we examine the merits and limitations of the Pararectus approach, specifically focusing on its utility in the surgical treatment of anterior column posterior hemitransverse acetabular fractures. Ultimately, the success of the individual patient's outcome is less dependent on the chosen approach and more on the surgeon's experience and expertise. Ideally, surgeons should be proficient in all these approaches to tailor the surgical strategy to the individual patient's requirements, thereby ensuring optimal outcomes.
AB - Beginning in France in the 1960s, the management of acetabular fractures has increasingly evolved toward surgical treatment strategies. The basic principles established by the pioneers of acetabular surgery, Letournel and Judet - anatomical reconstruction of the joint and stable osteosynthesis - remain unchanged. Modern advancements in surgical techniques aim to reduce access-related trauma and minimize complications. The notable rise in acetabular fractures among the elderly, which predominantly affect the anterior aspects of the acetabulum, has driven the development of less invasive, soft tissue-sparing anterior approaches. This evolution began with the ilio-inguinal approach in the 1960s, progressed to the modified Stoppa approach in the 2000s and, most recently, the Pararectus approach in the 2010s. Each of these approaches upholds the fundamental principles of effective acetabular fracture care, while offering distinct advantages and disadvantages. In this review, we examine the merits and limitations of the Pararectus approach, specifically focusing on its utility in the surgical treatment of anterior column posterior hemitransverse acetabular fractures. Ultimately, the success of the individual patient's outcome is less dependent on the chosen approach and more on the surgeon's experience and expertise. Ideally, surgeons should be proficient in all these approaches to tailor the surgical strategy to the individual patient's requirements, thereby ensuring optimal outcomes.
KW - Acetabular fractures
KW - Acetabulum
KW - Anterior column
KW - Anterior column posterior hemitransverse fracture
KW - Ilioinguinal approach
KW - Modified Stoppa approach
KW - Pararectus approach
KW - Posterior column
KW - Surgical approach
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001280376500001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s00402-024-05455-7
DO - 10.1007/s00402-024-05455-7
M3 - Review article
C2 - 39078483
SN - 0936-8051
JO - ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
JF - ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
ER -