A Comparative Study of Functional Outcomes in Anterior and Posterior Wall Acetabular Fractures Managed Using Modified Stoppa and Kocher-Langenbeck Approaches at a Tertiary Hospital in India

Background Surgical management of acetabular fractures remains technically demanding, particularly in resource-limited settings. This study evaluates the short-term functional and radiological outcomes of elementary acetabular fractures treated with approach-specific techniques. Methods A prospective study was conducted on 15 patients with isolated anterior or posterior wall acetabular fractures. Patients with anterior wall fractures (n = 8) underwent fixation via the modified Stoppa approach, while those with posterior wall fractures (n = 7) were treated using the Kocher-Langenbeck approach. Functional outcomes were assessed using the Harris Hip Score (HHS) at six months. Radiographic reduction quality was evaluated per Matta's criteria. Complications, operative time, and blood loss were recorded. Results Among the 15 patients with isolated acetabular wall fractures, 12 were male (80%), and road traffic accidents (RTAs) accounted for 12 cases (80%). Anterior wall fractures were observed in nine patients (60%) and posterior wall fractures in six (40%). Excellent or good HHS were achieved in 12 patients (80%) at the six-month follow-up. Satisfactory radiological reduction (<2 mm) was obtained in 12 patients (80%), while postoperative complications occurred in 4 patients (26.7%). Conclusion Tailoring the surgical approach to the fracture pattern yields favorable outcomes. The modified Stoppa approach offers distinct logistical and clinical advantages for anterior wall fractures, especially in low-resource environments. Early intervention, meticulous dissection, and context-specific protocols are critical for optimizing outcomes.