4.3 Article

The Impact of Surgical Approaches for Isolated Acetabulum Fracture on Sexual Functions: A Prospective Study

Journal

JOURNAL OF ORTHOPAEDIC TRAUMA
Volume 36, Issue 3, Pages 124-129

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOT.0000000000002246

Keywords

acetabulum fracture; sexual dysfunction; surgical approaches; functional outcome

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The study found that the posterior surgical approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients.
Objectives: To investigate the effects of surgical modalities for isolated acetabular fractures on the sexual functions of patients and their partners. Design: Prospective. Setting: Level I trauma centre. Patients/Participants: Sixty-five patients who had undergone open reduction and internal fixation because of isolated acetabular fractures who were sexually active before, together with their partners. Intervention: Patients operated on for isolated acetabular fractures were divided into 3 groups according to surgical approaches: the Kocher-Langenbeck approach (n = 36), ilioinguinal approach (n = 16), and modified Stoppa approach (n = 13). Main Outcome Measurements: Sexual functions of patients and their partners were evaluated with the 5-item version of the International Index of Erectile Function score and Female Sexual Function Index score preoperatively and at the postoperative first year after the rehabilitation period. Results: The mean age of the patients was 41.8 +/- 13.0 (18-69) years. In male patients, the mean 5-item version of the International Index of Erectile Function score had changed from 24.3 to 20.0 at the postoperative first year and the decrease in sexual function scores was less with the Kocher-Langenbeck approach. In female patients, the Female Sexual Function Index scores had decreased statistically significantly from 24.9 to 18.3 at the postoperative first year, but there was no statistically significant difference between surgical groups. Both male and female patients' partners' sexual function scores were also decreased at the postoperative first year. Conclusions: As a result of our study, it was observed that the posterior approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients.

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