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Open Reduction and Internal Fixation of Acetabular Fracture (Kocher-Langenbeck Approach)

intermediate Level

Primary Indication

Displaced posterior wall/column acetabular fractures

Danger Structures

  • undefined - Variable based on approach
  • undefined - Surrounding operative field
  • undefined - Bone surface
  • undefined - Joint surfaces if applicable

Visual Atlas

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We're currently sourcing high-quality anatomy diagrams for this procedure.

Step-by-Step Technique

1

Incision from PSIS curving over greater trochanter to lateral femur

2

Develop interval between gluteus maximus fibres

3

Identify and protect sciatic nerve throughout

4

Release short external rotators from greater trochanter

5

Tag piriformis and obturator internus for later repair

6

Expose posterior column and wall with careful capsulotomy

7

Reduce fracture fragments using ball spike pusher and reduction clamps

8

Provisionally fix with K-wires

9

Apply spring plate or reconstruction plate for posterior wall

10

Buttress plate along posterior column

11

Lag screws for large fragments

12

Check reduction with intraoperative fluoroscopy (AP, Judet views)

13

Repair capsule and short external rotators