Kocher Langenbeck approach for emergency acetabular fixation is done in all Except
Open fracture
Progressive sciatic nerve injury
Recurrent dislocation inspite of closed reduction and traction
None of the above
Progressive sciatic nerve injury "Sciatic nerve palsies as a result of the initial injury occur in approximately 10% to 15% of patients with acetabular fractures. Sciatic nerve injury as a result of surgery occurs in 2% to 6% of patients and is more often associated with posterior fracture patterns treated through the Kocher-Langenbeck and extensile exposures." - Campbell's operative ohopaedics 11/e Chapter 53 -Fractures of Acetabulum and Pelvis Despite searching extensively I could not get any relevant text explaining the rest of options. Here's some material on Kocher-Langenbeck approach, which might be useful. Ref: http://www.maitrise- ohop.com/ corpusmaitri/ohopaedichno74Jractures_cotyle/index_us.shtml The posterior Kocher-Langenbeck approach is probably the best-known and the easiest incision for the management of acetabular fractures. Indications of the Kocher-Langenbeck Approach The following fractures are always accessed through a Kocher-Langenbeck approach: - Posterior wall fractures; - Posterior column fractures; - Posterior column plus posterior wall fractures; - Juxtatectal or infratectal transverse fractures. The following fractures may be accessed through a Kocher-Langenbeck approach: - Transverse fractures through the acetabular roof. However, a lateral approach will often be preferred. - T-shaped fractures, especially if the anterior column is not excessively displaced. Where difficulties are encountered, a large lateral approach is often preferred . - Low both-column fractures that do not involve the iliac wing . The following fractures are never accessed through a Kocher-Langenbeck approach: - Both-column fractures; - Anterior column fractures; - Anterior column plus posterior hemitransverse fractures.