To evaluate the efficacy and the result of the ilioinguinal approach in the operative treatment of acetabular fractures.

A retrospective analysis was performed on 22 patients who were available for follow-up over one year. The reduction quality, clinical results, and radiographic results were analyzed based on the criteria of Matta. Complications were recorded as well.

Anatomical reduction (0-1 mm displacement) was achieved in 18 cases (81.9%) and imperfect reduction (2-3 mm displacement) was achieved in 4 cases (18.1%). Excellent clinical and radiographic results were graded in all of the 18 anatomically reduced fractures. The clinical results were excellent in 1 case, good in 2, and poor in 1; although radiographic results were good in 4 cases with imperfect reductions. Complications included 5 cases with a transient lateral femoral cutaneous nerve injury, which resolved during the follow-up period and 1 case with a partial femoral nerve palsy.

The ilioinguinal approach is effective for anterior wall, anterior column, and associated anterior and posterior hemitransverse fractures; as well as both column, transverse fracture, and T-shaped fractures. The risk of iatrogenic lateral femoral cutaneous nerve damage is relatively high, but there were no residual symptoms at the time of latest follow-up evaluation.