Complications of Acute Acetabular Fractures Surgical Treatment: Systematic Review

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Background.The combination of classical anterior and posterior approaches, as well as their modifications, is recognized as the most effective in acetabular fractures surgical treatment. The use of classical and modified approaches is accompanied by  serious  intra-  and  postoperative  complications  associated  primarily  with  the  duration  of  surgery,  significant  blood loss, tissue trauma, surgical site infection. The aim of review — to determine the main and most frequent complications associated with surgical approaches to the acetabulum. material and methods. Access to literature sources is carried out in the information systems and databases PubMed/Medline, Embase, Scopus, Сochran Library, eLibrary, Wiley Online Library. Keywords: acetabular fractures, surgical treatment, approach to the acetabulum, total hip replacement.

Results. The most common intraoperative complications are incorrect fragments reduction, sciatic nerve injury, less often — intraarticular implant position, damage to the superior gluteal artery and other vessels, among the early postoperative complications - wound infection, both superficial and deep, less often — venous thrombosis. Late postoperative complications are mainly represented  by  the  development  of  heterotopic  ossification,  post-traumatic  coxarthrosis,  less  often  revealed  aseptic necrosis of the femoral head, residual protrusion and secondary femoral head lesion. Conclusion. The main approach to the acetabulum are the ileo-inguinal and the Kocher-Langenbeck approach, as well as their combination.

Complications were more common using two approaches, especially in cases of simultaneous use. The main intraoperative complications are the sciatic nerve and the superior gluteal artery injury with posterior approaches, the femoral lateral cutaneous nerve with expanded ilio-femoral approach, and the obturator nerve with anterior approaches.

About the authors

A. I. Kolesnik

Priorov Central Institute for Trauma and Orthopedics

Author for correspondence.
ORCID iD: 0000-0003-1435-8743

Aleksandr I. Kolesnik— Dr. Sci. (Med.), Professor


Russian Federation

N. V. Zagorodniy

Priorov Central Institute for Trauma and Orthopedics; RUDN University

ORCID iD: 0000-0002-6736-9772

Nikolai  V.  Zagorodniy —  Dr.  Sci.  (Med.),  Professor


A. A. Ochkurenko

Priorov Central Institute for Trauma and Orthopedics

ORCID iD: 0000-0002-1078-9725

Aleksandr  A.  Ochkurenko —  Dr.  Sci.  (Med.),  Professor


A. F. Lazarev

Priorov Central Institute for Trauma and Orthopedics


Anatolii  F.  Lazarev—  Dr.  Sci.  (Med.),  Professor


E. I. Solod

Priorov Central Institute for Trauma and Orthopedics

ORCID iD: 0000-0001-7807-8981

Eduard I. Solod — Dr. Sci. (Med.)


S. V. Donchenko

Botkin City Clinical Hospitl

ORCID iD: 0000-0003-3341-7446

Sergei  V.  Donchenko —  Cand.  Sci.  (Med.)


I. M. Solodilov

Kursk City Clinical Hospital No. 4

ORCID iD: 0000-0001-8219-5582

Ivan  M.  Solodilov


D. A. Ivanov

Lytkarino City Hospital

ORCID iD: 0000-0002-5821-6774

Dmitrii  A.  Ivanov


A. V. Ovcharenko

Kaluga Regional Clinical Hospital of Emergency Medical Care named after K.N. Shevchenko

ORCID iD: 0000-0002-3014-4828

Anton V. Ovcharenko


V. V. Surikov

Russian Medical Academy of Continuing Postgraduate Education

ORCID iD: 0000-0003-3668-2376

Vladislav  V.  Surikov —  PhD  Student



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