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Orthopaedics Pelvis and Hip injuries 403ed994

Kocher langenback approach for emergency acetabular fixation is done in all Except-

A
Open fractures
B
Progressive sciatic nerve injury
C
Recurrent dislocation inspite of closed reduction and traction
D
Morel- Lavallee lesion
High-Yield Explanation
*Morel-Lavalle lesion is a localized area of subcutaneous fat necrosis over the lateral aspect of hip caused by same trauma that causes the acutabular fracture. The operation through it has been a/w a higher (12%) rate of post - operative infection , wound dehiscence and healing by secondary intention. The presence of a significant Morel-Lavallee lesion can be suspected by hypermobility of the skin and subcutaneous tissue in the affected area from the shear type separation of the subcutaneous tissue from the underlying fascia lata. Alternatively, some fractures can be treated through ilioinguinal approach, thus avoiding the affected area. *Therefore, in the presence of Morel - Lavalle lesion posterior kocher langenbeck approach is avoided. Ref: Essentials of ohopaedics surgery 3rd/e p.1219

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