Associated both-column acetabular fracture managed with anterior-only approach: a case report

Associated both-column (ABC) acetabular fractures are complex injuries often requiring combined surgical approaches, however this case evaluates the efficacy of an anterior-only technique. A 58-year-old male sustained an ABC fracture after a 3-meter fall, managed via a Pfannenstiel and ilioinguinal first-window approach. Fixation targeted the iliac crest (4.5 mm cannulated screws), comminuted iliac wing (calcaneal plate), and anterior column (reconstruction plate), achieving satisfactory reduction. Posterior fixation was not performed due to satisfactory intraoperative alignment. Pain, function, and quality of life were assessed over 24 months using the Visual Analog Scale (VAS), Majeed Pelvic Score, and SF-12, respectively. Outcomes were excellent: SF-12 Physical Component Summary 56.58, Mental Component Summary 60.76, Majeed Score 91, and VAS 0 at 24 months. This highlights the anterior-only approach’s success in select cases, emphasizing individualized treatment.