Comparison of Postoperative Complications Between Trochanter Flip Osteotomy and Kocher–Langenbeck Approaches for the Treatment of Femoral Head Fractures: A Systematic Review and Meta-analysis

Kim, Chul‐Ho; Sung, Dae Dong; Cho, Hyung-Chul; Yoon, Yong-Cheol

doi:10.1007/s43465-023-00846-1

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2024

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Cited by 2 publications

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Pipkin fractures: fracture type-specific management

Gänsslen,

Lindtner,

Krappinger

et al. 2024

Arch Orthop Trauma Surg

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Pipkin fractures: fracture type-specific management

Gänsslen,

Lindtner,

Krappinger

et al. 2024

Arch Orthop Trauma Surg

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Comparative cadaveric study of the Kocher–Langenbeck approach with and without trochanteric osteotomy in extended posterior wall fractures of the acetabulum

Orapiriyakul,

Kritsaneephaiboon,

Dissaneewate

et al. 2024

Preprint

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Introduction: Standard exposure, such as the Kocher–Langenbeck (KL) approach, has a limited ability to access the cranial and anterior portions of the posterior wall with an extended fracture line into the acetabular dome. Augmentation of the KL approach with trochanteric osteotomy (TO) has enhanced exposure in this area. This study aimed to compare the area of surgical exposure in the KL approach with and without additional TO and identify the most anterior exit point of the posterior wall in each surgical approach. The addition of TO to the KL approach significantly improves surgical exposure of the supero-anterior acetabular regions compared to the KL approach alone. Materials and Methods Ten fresh cadaveric hip specimens were used in this study. The KL approach was initially used for each specimen, followed by additional TO. Surgical exposures were marked, and measurements were taken for anterior and cranial exposure distances, surface area of bony exposure, and posterior wall arc angle (PWAA). Data were analysed using paired t-tests and Wilcoxon signed-rank tests. Results TO significantly increased the anterior exposure distance (65.83 mm vs. 49.07 mm) and acetabular surface area (43.95 cm2 vs. 33.51 cm2) compared to the KL approach alone. PWAA was also significantly higher in TO (52.55° vs. 27.63°), indicating enhanced anterior exposure. However, the increase in cranial exposure distance was not statistically significant. Conclusion The KL approach with TO significantly enhanced surgical exposure for posterior wall acetabular fractures, particularly in the anterior regions. For fractures with a PWAA of 0º–27º, the KL approach alone would be sufficient. Level of evidence: IV, cadaveric study

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Comparison of Postoperative Complications Between Trochanter Flip Osteotomy and Kocher–Langenbeck Approaches for the Treatment of Femoral Head Fractures: A Systematic Review and Meta-analysis

Cited by 2 publications

References 28 publications

Pipkin fractures: fracture type-specific management

Pipkin fractures: fracture type-specific management

Comparative cadaveric study of the Kocher–Langenbeck approach with and without trochanteric osteotomy in extended posterior wall fractures of the acetabulum

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