Modified ollier transtrochanteric approach for the treatment of acetabular fractures

Susan Mcdowell, Brian Mullis, Bradford S. Knight, Laurence E. Dahners

Research output: Contribution to journalArticle

Abstract

The purpose of this retrospective clinical study was to evaluate the rates of wound and neurologic complications and clinically significant heterotopic ossification, Brooker stage 3 and 4, with the modified Ollier transtrochanteric approach for the treatment of acetabular fractures. The study group comprised 94 consecutive patients (95 acetabuli) who had unstable acetabular fractures requiring surgical fixation. All patients were treated with open reduction internal fixation via the Ollier approach by a single surgeon (L.E.D.). Demographic and clinical information regarding rates of wound and neurologic complications and remaining articular stepoff at fixation was obtained from a chart review. The degree of heterotopic ossification was graded from standard anteroposterior pelvis radiographs according to the Brooker classification. Six (6%) patients underwent reoperation for infection; however, only 3 (3%) of these patients had deep infections. Three (3%) patients had iatrogenic sciatic nerve injuries; only 1 patient had persistent sensory changes at final follow-up. Thirteen (18%) of the 73 patients with radiographs available for review at a minimum of 3-month follow-up had Brooker grade III heterotopic ossification and 1 (1%) patient had grade IV. Five (5%) patients underwent excision of heterotopic ossification. Fourteen (17%) of 81 patients had no radiographic union of the greater trochanteric osteotomy, but none of these patients required further surgery. The complication rates of the Ollier approach in this study compare favorably with alternative surgical approaches reported in large series. We believe this approach provides excellent exposure without increasing the risk of complications.

Original languageEnglish
JournalOrthopedics
Volume35
Issue number2
DOIs
StatePublished - Feb 2012

Fingerprint

Heterotopic Ossification
Therapeutics
Nervous System
Wounds and Injuries
Sciatic Nerve
Osteotomy
Infection
Pelvis
Reoperation
Retrospective Studies
Joints
Demography

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Modified ollier transtrochanteric approach for the treatment of acetabular fractures. / Mcdowell, Susan; Mullis, Brian; Knight, Bradford S.; Dahners, Laurence E.

In: Orthopedics, Vol. 35, No. 2, 02.2012.

Research output: Contribution to journalArticle

Mcdowell, Susan ; Mullis, Brian ; Knight, Bradford S. ; Dahners, Laurence E. / Modified ollier transtrochanteric approach for the treatment of acetabular fractures. In: Orthopedics. 2012 ; Vol. 35, No. 2.
@article{56114f44541b42d28991f7c83b565b6e,
title = "Modified ollier transtrochanteric approach for the treatment of acetabular fractures",
abstract = "The purpose of this retrospective clinical study was to evaluate the rates of wound and neurologic complications and clinically significant heterotopic ossification, Brooker stage 3 and 4, with the modified Ollier transtrochanteric approach for the treatment of acetabular fractures. The study group comprised 94 consecutive patients (95 acetabuli) who had unstable acetabular fractures requiring surgical fixation. All patients were treated with open reduction internal fixation via the Ollier approach by a single surgeon (L.E.D.). Demographic and clinical information regarding rates of wound and neurologic complications and remaining articular stepoff at fixation was obtained from a chart review. The degree of heterotopic ossification was graded from standard anteroposterior pelvis radiographs according to the Brooker classification. Six (6{\%}) patients underwent reoperation for infection; however, only 3 (3{\%}) of these patients had deep infections. Three (3{\%}) patients had iatrogenic sciatic nerve injuries; only 1 patient had persistent sensory changes at final follow-up. Thirteen (18{\%}) of the 73 patients with radiographs available for review at a minimum of 3-month follow-up had Brooker grade III heterotopic ossification and 1 (1{\%}) patient had grade IV. Five (5{\%}) patients underwent excision of heterotopic ossification. Fourteen (17{\%}) of 81 patients had no radiographic union of the greater trochanteric osteotomy, but none of these patients required further surgery. The complication rates of the Ollier approach in this study compare favorably with alternative surgical approaches reported in large series. We believe this approach provides excellent exposure without increasing the risk of complications.",
author = "Susan Mcdowell and Brian Mullis and Knight, {Bradford S.} and Dahners, {Laurence E.}",
year = "2012",
month = "2",
doi = "10.3928/01477447-20120123-03",
language = "English",
volume = "35",
journal = "Orthopedics",
issn = "0147-7447",
publisher = "Slack Incorporated",
number = "2",

}

TY - JOUR

T1 - Modified ollier transtrochanteric approach for the treatment of acetabular fractures

AU - Mcdowell, Susan

AU - Mullis, Brian

AU - Knight, Bradford S.

AU - Dahners, Laurence E.

PY - 2012/2

Y1 - 2012/2

N2 - The purpose of this retrospective clinical study was to evaluate the rates of wound and neurologic complications and clinically significant heterotopic ossification, Brooker stage 3 and 4, with the modified Ollier transtrochanteric approach for the treatment of acetabular fractures. The study group comprised 94 consecutive patients (95 acetabuli) who had unstable acetabular fractures requiring surgical fixation. All patients were treated with open reduction internal fixation via the Ollier approach by a single surgeon (L.E.D.). Demographic and clinical information regarding rates of wound and neurologic complications and remaining articular stepoff at fixation was obtained from a chart review. The degree of heterotopic ossification was graded from standard anteroposterior pelvis radiographs according to the Brooker classification. Six (6%) patients underwent reoperation for infection; however, only 3 (3%) of these patients had deep infections. Three (3%) patients had iatrogenic sciatic nerve injuries; only 1 patient had persistent sensory changes at final follow-up. Thirteen (18%) of the 73 patients with radiographs available for review at a minimum of 3-month follow-up had Brooker grade III heterotopic ossification and 1 (1%) patient had grade IV. Five (5%) patients underwent excision of heterotopic ossification. Fourteen (17%) of 81 patients had no radiographic union of the greater trochanteric osteotomy, but none of these patients required further surgery. The complication rates of the Ollier approach in this study compare favorably with alternative surgical approaches reported in large series. We believe this approach provides excellent exposure without increasing the risk of complications.

AB - The purpose of this retrospective clinical study was to evaluate the rates of wound and neurologic complications and clinically significant heterotopic ossification, Brooker stage 3 and 4, with the modified Ollier transtrochanteric approach for the treatment of acetabular fractures. The study group comprised 94 consecutive patients (95 acetabuli) who had unstable acetabular fractures requiring surgical fixation. All patients were treated with open reduction internal fixation via the Ollier approach by a single surgeon (L.E.D.). Demographic and clinical information regarding rates of wound and neurologic complications and remaining articular stepoff at fixation was obtained from a chart review. The degree of heterotopic ossification was graded from standard anteroposterior pelvis radiographs according to the Brooker classification. Six (6%) patients underwent reoperation for infection; however, only 3 (3%) of these patients had deep infections. Three (3%) patients had iatrogenic sciatic nerve injuries; only 1 patient had persistent sensory changes at final follow-up. Thirteen (18%) of the 73 patients with radiographs available for review at a minimum of 3-month follow-up had Brooker grade III heterotopic ossification and 1 (1%) patient had grade IV. Five (5%) patients underwent excision of heterotopic ossification. Fourteen (17%) of 81 patients had no radiographic union of the greater trochanteric osteotomy, but none of these patients required further surgery. The complication rates of the Ollier approach in this study compare favorably with alternative surgical approaches reported in large series. We believe this approach provides excellent exposure without increasing the risk of complications.

UR - http://www.scopus.com/inward/record.url?scp=84857474073&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857474073&partnerID=8YFLogxK

U2 - 10.3928/01477447-20120123-03

DO - 10.3928/01477447-20120123-03

M3 - Article

C2 - 22310395

AN - SCOPUS:84857474073

VL - 35

JO - Orthopedics

JF - Orthopedics

SN - 0147-7447

IS - 2

ER -