Abstract: Objective To evaluate the feasibility and efficacy of Stoppa approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption. Methods Clinical data of 16 cases of anterior pelvic ring fractures complicated with posterior disruption during January 2012 and July 2015 were retrospectively analyzed. All patients were treated with emergency operation with the Stoppa approach of open reduction and internal fixation of the pelvis combined with urethral realignment by traction and primary urethra suturing or partial suturing. All patients were followed up for 6 to 36 months. The reduction of fracture and recovery of function were evaluated with Tometta and Majeed score. The urethral repair effect was evaluated with postoperative clinical examination and patients subjective feelings. Results The mean length of incision was 12 cm. The average operation time was 136 min. According to the Tometta score classification, the results were excellent in 11 cases, good in 3 cases, and fair in 2 cases. According to the Majeed score classification, the results were excellent in 12 cases, good in 3 cases, and fair in 1 case. After the urinary catheter was removed, 12 patients achieved good urination, with the mean maximal urine flow being 18.5 mL/s; 4 patients developed dysuria; 6 patients had penile erectile difficulties; and 2 patients had urinary incontinence. Conclusion The Stoppa approach is a safe approach, which can provide clear surgical field to repair the urethral disruption and fix the anterior pelvic ring fractures. It can be an ideal approach in the treatment of anterior pelvic ring fractures complicated with posterior urethral disruption.

Key words: Fracture fixation, Pelvic fractures, Posterior urethral disruption, Stoppa approach