Cole and Bolhofner describe a modified Stoppa anterior intrapelvic approach for surgical fixation of displaced acetabular fractures, adapted from hernia surgery. The paper details operative technique and reports preliminary outcomes in 55 consecutive patients treated between 1991–1992, asking whether this approach can achieve equivalent reductions while avoiding the approach-specific complications of extrapelvic methods.
When managing anterior column, both-column, transverse, T-shaped, or anterior column with posterior hemitransverse acetabular fractures — especially in patients where heterotopic ossification prophylaxis is contraindicated or sciatic nerve risk from a posterior approach is a concern.
The modified Stoppa approach provides direct medial wall visualization and indirect plate reduction options through a single low midline incision.
Hard contraindications to keep in mind: fractures older than 3 weeks, pure posterior pathology, sciatic buttress comminution, abdominal distention/ileus, and a pre-existing suprapubic catheter.
Cole and Bolhofner describe a modified Stoppa anterior intrapelvic approach for surgical fixation of displaced acetabular fractures, adapted from hernia surgery. The paper details operative technique and reports preliminary outcomes in 55 consecutive patients treated between 1991–1992, asking whether this approach can achieve equivalent reductions while avoiding the approach-specific complications of extrapelvic methods.
When managing anterior column, both-column, transverse, T-shaped, or anterior column with posterior hemitransverse acetabular fractures — especially in patients where heterotopic ossification prophylaxis is contraindicated or sciatic nerve risk from a posterior approach is a concern.
The modified Stoppa approach provides direct medial wall visualization and indirect plate reduction options through a single low midline incision.
Hard contraindications to keep in mind: fractures older than 3 weeks, pure posterior pathology, sciatic buttress comminution, abdominal distention/ileus, and a pre-existing suprapubic catheter.