The Kocher-Langenbeck approach is the workhorse for the reduction and fixation of hip fractures that require fixation via a posterior approach1,2. Review the patient's general condition and imaging studies, plan the sequence of reduction and fixation, and make sure that all of the necessary equipment is available. Induce anesthesia, administer intravenous antibiotics as per local hospital protocol, apply antiembolism stockings, and insert a Foley catheter to the bladder. Make an incision that is 15 to 20 cm long and has 2 parts (proximal and distal), which are centered over the greater trochanter. The reconstruction of posteriorly based fractures depends on the specific fracture type, and the goal is to provide stable column fixation and anatomical reconstruction of the acetabular articular surface, with column fixation performed before the reconstruction of the posterior wall. Meticulous hemostasis, application of drains, and watertight closure are the final steps of the operation. The Kocher-Langenbeck approach is the workhorse for the surgical management of acetabular fractures and provides sufficient access to the majority of posterior based acetabular fractures15.

The ilioinguinal approach is the standard approach for the open reduction and internal fixation of the majority of displaced, anteriorly based acetabular fractures as it offers wide access to the acetabulum, is extensile, and has been associated with enhanced recovery. Review the patient's general condition and imaging studies and plan the sequence of reduction and fixation. Position the patient supine on the fracture table, induce anesthesia, prepare the surgical field, administer intravenous antibiotics, and apply traction. Make a long curvilinear incision over the affected lower flank, develop the 3 working windows, and reduce and stabilize the fracture while protecting the neurovascular structures and the bladder (Video 2). For reduction of a both-column acetabular fracture, connect the mobile parts of the acetabulum to the iliac segment that is attached to the sacrum, noting that, in most cases, the usual sequence involves the reduction of the anterior column to the intact ilium followed by the reduction of the posterior column (Video 7). Perform meticulous hemostasis, apply drains, and ensure watertight closure, which are the final steps of the operation (Video 8). The ilioinguinal approach remains 1 of the standard approaches for the management of acetabular fractures10.

Introduction: Osteoporotic vertebral fractures (OVFs) are the most common type of fragility fractures. They have a significant and usually detrimental impact on the patient’s functional status and mortality rate, constituting a substantial burden for the patients, their families, and the healthcare system. This narrative review aims to summarize the current knowledge of osteoporotic vertebral fractures and secondary fracture prevention. Methods: A comprehensive literature search was conducted across major medical databases, including PubMed, Scopus, and Web of Science. Relevant studies, guidelines, and reviews published were analyzed to provide a broad perspective on the topic. Results: Diagnosis of OVFs is based on history, clinical examination, and plain lateral radiographs of the spine. Their management is mainly non-operative, with surgery being reserved for specific indications. Successful management of osteoporotic vertebral fractures entails alleviating pain, early restoration of mobility, and secondary fracture prevention. Prevention of the next osteoporotic fracture is paramount and should be an integral element of their management. The Fracture Liaison Service (FLS) is the main contemporary service that serves this purpose. Discussion: Diagnosis of OVFs is simple but requires vigilance from the clinicians. Early, accurate diagnosis is essential to initiate appropriate treatment and provide the opportunity for secondary fracture prevention.