Pararectus approach to the AO B2.2 pelvic fracture: early functional and radiological outcomes

Eur J Orthop Surg Traumatol. 2023 May;33(4):829-836. doi: 10.1007/s00590-022-03216-z. Epub 2022 Feb 4.

Abstract

Purpose: The pararectus approach is used to treat acetabular fractures; however, it remains unclear whether it can be used to treat pelvic fractures. This study aimed to examine the outcomes of patients with a pelvic ring fracture treated with this approach.

Methods: Seven patients with AO B2.2 pelvic fractures treated with the pararectus approach were included. Patients' pain was assessed pre- and postoperatively with a numerical rating scale. Radiological evaluations included inlet and outlet ratios and pelvic symmetry. Functional outcomes, including Merle d'Aubigné and Majeed scores, were also recorded for 12 months.

Results: One patient experienced obturator nerve neuropraxia. Pain scores ranged from 2.3-8.0 to 2.0-3.1 points before and after surgery, respectively. Radiological findings revealed satisfactory outcomes. The maximal gap of the affected ilium reduced from 8.6-20.2 to 0-3.4 mm, from 6.8-17.9 to 0-4.4 mm, and from 3.7-20.3 to 0-3.2 mm in the axial, sagittal, and coronal views, respectively. Based on multiple evaluations, functional outcomes were improved for all patients.

Conclusion: The pararectus approach can be used safely and satisfactorily to treat AO B 2.2 pelvic fractures.

Keywords: Pararectus approach; Pelvic fracture; Quality of reduction; Radiological outcome.

MeSH terms

  • Acetabulum / surgery
  • Fracture Fixation, Internal / adverse effects
  • Fractures, Bone* / surgery
  • Hip Fractures* / surgery
  • Humans
  • Pelvic Bones* / surgery
  • Radiography
  • Retrospective Studies
  • Treatment Outcome