Complex acetabular fractures: a transtrochanteric lateral surgical approach.

Open surgery is recommended for complex fractures whenever primary conservative treatment fails to satisfactorily reduce the femoral head and the weight-bearing dome of the acetabulum. Surgical exposure has been a major problem in attempting open reduction of these fractures. The classification of acetabular fractures noted above is a useful guide to the indications for open operation. A transtrochanteric lateral approach provides a good extra and intraarticular access to the acetabulum. The excellent clinical results achieved in 28 cases of complex acetabular fractures with a mean of 5.7 year follow-up testify to the value of this approach.