background
acetabular anterior wall fracture with preservation of the pelvic brim is
extremely rare. it is different from anterior wall fracture classified by judet and
letournel. few studies have reported cases treated by open reduction and
internal fixation via the smith-petersen or iliofemoral approach.
case summary
we report a 48-year-old chinese woman who had difficulty moving her right hip
from abduction and external rotation after falling from 3 m. pelvic radiograph
and three-dimensional reconstruction of computed tomography revealed
acetabular anterior wall fractures combined with fractures of the anterior inferior
iliac spine and the iliac wing but not involving the pelvic brim. first, the patient
underwent interim management by closed reduction of the hip dislocation and
skin traction for 6 d. then, we used a modified pararectus approach for treatment
to fix the acetabular fractures with a reconstruction plate and nonlocking t-shape
plate. at the 9-mo follow-up, the patient could walk painlessly without necrosis
of the femoral head or heterotopic ossification, and the x-rays and computed
tomography scan reconstructions showed good bone union.
conclusion
the modified pararectus approach described here can facilitate exposure,
reduction, and osteosynthesis for atypical acetabular fracture with less
invasiveness.
key words: acetabulum; fracture; modified; pararectus approach; case report
