Abstract
OBJECTIVE: To investigate the reduction quality and hip function after internal fixation of acetabular double column fractures combined with posterior wall fractures using the Stoppa approach compared to the ilioinguinal approach. METHODS: A total of 94 patients admitted to our hospital from October 2016 to October 2021 were included. All patients were diagnosed with acetabular double-column fractures combined with posterior wall fractures. Based on the random number table method, patients were divided into the Stoppa group (treated via the Stoppa approach) and the control group (treated via the conventional ilioinguinal approach), with 47 cases in each group. Postoperative reduction quality and hip function were recorded and compared between the groups. Multivariate logistic regression analysis was performed to identify risk factors affecting surgical outcomes. RESULTS: The Stoppa group demonstrated significantly less intraoperative bleeding, shorter operation time, reduced postoperative drainage volume, shorter drainage tube retention time, and shorter hospital stay compared to the control group (P < 0.05). Postoperatively, the Stoppa group had a significantly lower VAS score (2.90 ± 0.72) and higher Harris scores than those in the control group (5.62 ± 1.18) (P < 0.05). The excellent and good rate of fracture reduction in the Stoppa group was significantly higher (P < 0.05). ROM in hip extension and flexion, internal-external rotation, and Merle-d’Aubigne-Postel scores were also significantly higher in the Stoppa group (P < 0.05). The quality of life score post-operation was higher in the Stoppa group (P < 0.05). Univariate analysis indicated that timing of surgery, fracture type, presence of bone fragments in the joint, cartilage surface injury, surgical approach, and heterotopic ossification significantly influenced surgical outcomes (P < 0.05). Multivariate analysis showed that surgery timing (1–2 weeks) and heterotopic ossification were risk factors, while the Stoppa approach was associated with improved outcomes across all measures (P < 0.05). CONCLUSION: Compared to the ilioinguinal approach, the Stoppa approach provides patients with acetabular double column fractures and posterior wall involvement with significantly reduced operation time and blood loss, shortens hospitalization duration, reduces postoperative pain, enhances reduction quality, and improves hip joint function. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-025-09148-z.