Outcome of Modified Stoppa Approach for Fixation of Acetabular Fractures.


  • Umair Nadeem Assistant Professor, Ghurki Trust Teaching Hospital Lahore
  • Zubair Khalid Post Graduate Resident Orthopaedic, Ghurki Trust Teaching Hospital Lahore
  • Atif Ali Medical Officer, Ghurki Trust Teaching Hospital Lahore
  • Tallal Abdullah Medical Officer Ghurki Trust Teaching Hospital Lahore
  • Atiq uz Zaman Professor, Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital Lahore
  • Shehzad Javaed Professor, Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital Lahore
  • Amer Aziz Professor, Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital Lahore


Modified Stoppa approach, fixation, acetabular fractures, outcome, complications.


Objective: To determine the outcome of modified stoppa approach for fixation of acetabular fractures in terms of operative time, complications, radiological and clinical outcome criteria of Matta.

Method: This was a descriptive study conducted from 12th September 2018 to 12th January 2021 in Orthopedic Unit of Ghurki Trust Teaching Hospital Lahore. All patients with acetabular fractures meeting the inclusion criteria were operated via modified Stoppa approach. Outcome was assessed in terms of mean operative time, complications rate and Matta’s radiological and clinical criteria at 16th week.

Results: The total number of patients in this study were 52. The mean age was 31.1±12.4 years. Male patients were 36(69.2%) males and female 16(30.8%). The fractures were associated type in 34(65.3%) and elementary in 18(34.6%) patients. The mean follow-up time was 4.8 months (range 6 to 11months). The mean operative time was 176.32±88.29 min. According to Matta’s radiological criteria post operative anatomical reduction was achieved in 39(75%) cases, imperfect in 8(15.3%) cases and poor in 5(9.6%) cases. The clinical results were excellent in 13(25%) cases, good in 31(59.6%) cases and poor in 8(15.3%) cases. Superficial surgical site infection (SSI) was noted in 2(4.3%) patients and resolved with antibiotics.

Conclusion: Modified Stoppa approach is an effective and safe alternative to Ilioinguinal approach for acetabular fractures yielding satisfactory radiological and clinical outcome with minimal complications.


Boudissa M, Francony F, Kerschbaumer G, Ruatti S, Milaire M, Merloz P, et al. Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: Retrospective study of 414 patients over 10 years. Orthop Traumatol Surg Res 2017;103(3):335-339.

Lal SR. Outcome of surgical treatment for displaced acetabular fractures: A prospective study. Rev Bras Ortop 2017;53(4):482-488.

Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction: preliminary report. J Bone Joint Surg Am 1964;46(8):1615-1646.

Chen J, Liu H, Wang C, Lin X, Gu C, Fan S. Internal fixation of acetabular fractures in an older population using the lateral-rectus approach: shortterm outcomes of a retrospective study. J Orthop Surg Res. 2019;14(1):444-450.

Ryan SP, Manson TT, Sciadini MF, Nascone JW, LeBrun CT, Castillo RC, et al. Functional outcomes of elderly patients with nonoperatively treated acetabular fractures that meet operative criteria. J Orthop Trauma 2017;31(12):644–649.

Ziran N, Soles GLS, Matta JM. Outcomes after surgical treatment of acetabular fractures: a review. Patient Saf Surg 2019;13:16-20.

Prasartritha T, Chaivanichsiri P. The study of broken quadrilateral surface in fractures of the acetabulum. Int Orthop 2013;37(6):1127–1134.

Hammad AS, El-Khadrawe TA. Accuracy of reduction and early clinical outcome in acetabular fractures treated by the standard ilio-inguinal versus the Stoppa/iliac approaches. Injury 2015;46(2):320-326.

Rives J, Stoppa R, Fortesa L, Nicaise H. Dacron patches and their place in surgery of groin hernia: 65 cases collected from a complete series of 274 hernia operations. Ann Chir 1968;22(3):159-171.

Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am 1984;64(2):269-285.

Hirvensalo E, Lindahl J, Bostman O. A new approach to the internal fixation of unstable pelvic fractures. Clin Orthop Relat Res 1993;(297):28-32.

Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach: description of operative technique and preliminary treatment results. Clin Orthop Relat Res 1994;(305):112-123.

Kim HY, Yang DS, Park CK, Choy WS. Modified Stoppa approach for surgical treatment of acetabular fracture. Clin Orthop Surg 2015;7(1):29-38.

Tsang B, McKee J, Engels PT, Paton-Gay D, Widder SL. Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting. World J Emerg Surg 2013;8(1):39-45.

Mesbahi SAR, Ghaemmaghami A, Ghaemmaghami S, Farhadi P. Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience. Bull Emerg Trauma 2018;6(1):37-44.

Letournel E, Judet R. Fractures of the acetabulum. Berlin:Springer-Verlag;1974:45-52.

Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach: a 10-year perspective. Clin Orthop Relat Res 1994;(305):10-19.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51(4):737-755.

Sagi HC, Afsari A, Dziadosz D: The anterior intra-pelvic (modified Rives Stoppa) approach for fixation of acetabular fractures. J Orthop Trauma 2010; 24(5):263-270.

Hirvensalo E, Lindahl J, Kiljunen V: Modified and new approaches for pelvic and acetabular surgery.Injury 2007; 38(4):431-441.

Singh S V, Chopra R K, Puri G, Pheroz M, Kumar S,Bansal A, et al.Clinico-Radiological Evaluation of Modified Stoppa Approach in Treatment of Acetabulum Fractures. Cureus 2020; 2(9): e10193. doi:10.7759/cureus.10193

Borrelli J Jr, Goldfarb C, Ricci W, Wagner JM, Engsberg JR. Functional outcome after isolated acetabular fractures. J Orthop Trauma 2002;16(2):73-81.

Matta JM, Merritt PO. Displaced acetabular fractures. Clin Orthop Relat Res 1988;(230):83-97.

Pantazopoulos T, Mousafiris C. Surgical treatment of central acetabular fractures. Clin Orthop Relat Res 1989;(246):57-64.

Guo HZ, He YF, He WQ. Modified stoppa approach for pelvic and acetabular fracture treatment. Acta Ortop Bras 2019;27(4):216-219.

Jain M, Kumar P, Tripathy SK, Behera S, Rana R, Das S. Clinico-radiological outcomes of using Modified Stoppa approach for treating acetabular fractures: An Institutional Review. Cureus 2020;12(4):431-435.




How to Cite

Umair Nadeem, Zubair Khalid, Atif Ali, Tallal Abdullah, Atiq uz Zaman, Shehzad Javaed, & Amer Aziz. (2021). Outcome of Modified Stoppa Approach for Fixation of Acetabular Fractures. Journal of Pakistan Orthopaedic Association, 33(02), 57–61. Retrieved from http://jpoa.org.pk/index.php/upload/article/view/533

Most read articles by the same author(s)