Kocher Langenbeck approach for emergency acetabular fixation is done in all Except -
Morel - Lavalle lesion is a localized area of subcutaneous fat necrosis over the lateral aspect of hip caused by same trauma that causes the acetabular fracture. The operation through it has been a/w a higher (12%) rate of post­operative infection, wound dehiscence and healing by secondary intention. The presence of a significant Morel-Lavallee lesion can be suspected by hypermobility of the skin and subcutaneous tissue in the affected area from the shear-type separation of the subcutaneous tissue from the underlying fascia lata. Alternatively, some fractures can be treated through ilioinguinal approach, thus avoiding the affected area.
Therefore, In the presence of Morel-Lavalle lesion posterior kocher langenbeck approach is avoided.
Open fracture
Progressive sciatic nerve injury
Recurrent dislocation inspite of closed reduction and traction
Morel - Lavallee lesion