The Impact of Surgical Approaches for Isolated Acetabulum Fracture on Sexual Functions: A Prospective Study.

OBJECTIVES

To investigate the effects of surgical modalities for isolated acetabular fractures on the sexual functions of patients and their partners.

DESIGN

Prospective.

SETTING

Level I trauma centre.

PATIENTS/PARTICIPANTS: Sixty-five patients who had undergone open reduction and internal fixation because of isolated acetabular fractures who were sexually active before, together with their partners.

INTERVENTION

Patients operated on for isolated acetabular fractures were divided into 3 groups according to surgical approaches: the Kocher-Langenbeck approach (n = 36), ilioinguinal approach (n = 16), and modified Stoppa approach (n = 13).

MAIN OUTCOME MEASUREMENTS

Sexual functions of patients and their partners were evaluated with the 5-item version of the International Index of Erectile Function score and Female Sexual Function Index score preoperatively and at the postoperative first year after the rehabilitation period.

RESULTS

The mean age of the patients was 41.8 ± 13.0 (18-69) years. In male patients, the mean 5-item version of the International Index of Erectile Function score had changed from 24.3 to 20.0 at the postoperative first year and the decrease in sexual function scores was less with the Kocher-Langenbeck approach. In female patients, the Female Sexual Function Index scores had decreased statistically significantly from 24.9 to 18.3 at the postoperative first year, but there was no statistically significant difference between surgical groups. Both male and female patients' partners' sexual function scores were also decreased at the postoperative first year.

CONCLUSIONS

As a result of our study, it was observed that the posterior approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients.

LEVEL OF EVIDENCE

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.