Kocher Langenbeck approach for emergency acetabular fixation is done in all Except
Correct Answer: Progressive sciatic nerve injury
Description: Progressive sciatic nerve injury "Sciatic nerve palsies as a result of the initial injury occur in approximately 10% to 15% of patients with acetabular fractures. Sciatic nerve injury as a result of surgery occurs in 2% to 6% of patients and is more often associated with posterior fracture patterns treated through the Kocher-Langenbeck and extensile exposures." - Campbell's operative ohopaedics 11/e Chapter 53 -Fractures of Acetabulum and Pelvis Despite searching extensively I could not get any relevant text explaining the rest of options. Here's some material on Kocher-Langenbeck approach, which might be useful. Ref: http://www.maitrise- ohop.com/ corpusmaitri/ohopaedichno74Jractures_cotyle/index_us.shtml The posterior Kocher-Langenbeck approach is probably the best-known and the easiest incision for the management of acetabular fractures. Indications of the Kocher-Langenbeck Approach The following fractures are always accessed through a Kocher-Langenbeck approach: - Posterior wall fractures; - Posterior column fractures; - Posterior column plus posterior wall fractures; - Juxtatectal or infratectal transverse fractures. The following fractures may be accessed through a Kocher-Langenbeck approach: - Transverse fractures through the acetabular roof. However, a lateral approach will often be preferred. - T-shaped fractures, especially if the anterior column is not excessively displaced. Where difficulties are encountered, a large lateral approach is often preferred . - Low both-column fractures that do not involve the iliac wing . The following fractures are never accessed through a Kocher-Langenbeck approach: - Both-column fractures; - Anterior column fractures; - Anterior column plus posterior hemitransverse fractures.
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