136 Evaluating Surgical Approaches for Acetabular Fractures: Modified Stoppa vs. Ilioinguinal Approach

Abstract Background Epidemiological studies indicate a rising incidence of acetabular fractures. The key to successful treatment of displaced acetabular fractures lies in the anatomical reduction of the articular surface, stable fixation, and the selection of an appropriate surgical approach to achieve optimal clinical outcomes. Aim To perform a systematic review to compare between modified Stoppa approach and the ilioinguinal approach regarding reduction quality, Blood loss, Operative time, and Complications in acetabular fractures. Method Two independent authors conducted a systematic search of PubMed, Web of Science, and the Cochrane Library for relevant articles. A total of twelve studies were included, encompassing 714 patients: 396 who underwent the Modified Stoppa approach and 318 who received the ilioinguinal approach, between 2013 and 2020. Search terms included "anterior intra-pelvic approach," "comparison," "Stoppa Approach," "Ilioinguinal Approach," "Pelvic fractures," "Acetabular fractures," and "Pelvi-Acetabular Fractures." Results Twelve studies met our inclusion criteria. The Modified Stoppa approach demonstrated a statistically significant reduction in operative time compared to the Ilioinguinal approach. Postoperative outcomes were significantly better with the Modified Stoppa approach. There was no significant difference between the two approaches regarding postoperative complications, except for nerve injury, which was more prevalent with the Ilioinguinal approach. Conclusion Our findings suggest that the selection of the Modified Stoppa or Ilioinguinal approach should be based on patient characteristics, fracture type, and surgeon expertise. The Modified Stoppa approach demonstrates superior clinical outcomes, including shorter operative time, reduced intraoperative bleeding, and potentially fewer complications.