Document Type : RESEARCH PAPER
Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Orthopedic Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Objectives: Displaced acetabular fractures are complex injuries that necessitate precise surgical
intervention. Obturator nerve injuries occur in approximately 2% of cases. The modified Stoppa
approach, offering enhanced exposure of the quadrilateral plate, has gained attraction as an alternative
technique for anterior acetabular fractures. However, its proximity to the obturator nerve poses a risk
of iatrogenic injury. This study aimed to investigate the incidence of nerve injuries and functional
outcomes in patients undergoing the modified Stoppa approach for traumatic acetabular fractures.
Methods: This retrospective study involved 86 patients with anterior column fractures, whose data were
prospectively collected. The fractures were treated using the modified Stoppa approach. Exclusion criteria were
pathological fractures, alternative surgical approaches, prior nerve injuries, hip issues, refusal to participate, or
inadequate follow-up. Data collection involved pre-operative imaging, thorough post-operative neurological
assessments, and post-operative radiographic evaluation. Functional outcomes were assessed using the Harris Hip
Results: Most patients were male (n=54) with a mean age of 40±17.3 years. Post-operative infection occurred in
six cases, with resolution in four through antibiotics and two necessitating device removal. Obturator nerve damage
was detected in 14 patients, comprising nine traumatic and five iatrogenic cases. During the follow-up, symptoms
improved in all patients, except for the four patients with iatrogenic nerve damage.
Conclusion: Traumatic nerve injuries generally heal naturally over time. In contrast, iatrogenic injuries have a less
optimistic prognosis, potentially resulting in lasting neurological deficits.
Level of evidence: III