ACETABULAR FRACTURES - A POSTERIOR PERIGL UTEAL APPROACH

Purpose of the study This approach was developed to avoid gluteus maxi mus muscle injury which is divided when using the common Langenbeck-Ko cher approach. The posterior perigluteal approach also provides better visualization of the posterior aspect of the acetabulum. Material and Methods A semi-circular incision is made from the fascia lata at the anterior aspect of the greater trochanter and then directed to the pos terio-superior iliac spine. The gluteus maximus is then simply retract ed medially with blunt retractors. Sixty eight acetabular fractures ha ve been operated with this approach including both mixed and complex f ractures of the posterior column. Occasionaly fractures of both column s have been operated in two procedures, one posterior and then a secon d anterior approach. Results The posterior perigluteal approach preser ves gluteus maximus muscle tone. it seems to avoid postoperative ossif ication Conclusion We propose an approach which, compared to the Lange nbeck-Kocher approach, is less traumatic, and as easy to perform.