The most significant weight-bearing joint is the hip joint and thus any fractures localized to it are one of the most difficult ones to manage. Acetabular fractures occur intra-articularly within the hip joint. An early surgery with anatomical reduction and rehabilitation has been predominantly the only treatment known for displaced acetabular fractures to decrease clinical prognosis and minimize complications [[1], [2], [3], [4]].

The pioneering work for internal fixation of fractures of the pelvic ring and acetabulum was done by Judet and Letournel and they were the first to introduce the ilioinguinal approach for operative treatment [1,2]. This approach is commonly used in management of anterior column and wall fractures (AC + AW), associated anterior column and posterior hemi transverse fractures (ACPHT), both-column fractures (ABC) [1,2,5]. The entire inner side of the innominate bone is well exposed through the ilioinguinal approach. However, it is said to present an inherent risk to the neurovascular systems because of their closeness to the surgical cut plane, including the femoral nerve and external iliac vessels [5].

Thereafter, Rives and Stoppa established the Stoppa method as a sub peritoneal median approach for the management of hernias of groin [6]. It was followed by Hirvensalo et al. and Cole and Bolhofne introducing another strategy in the early 1990s to approximate the pelvis and anterior part of acetabulum [7,8]. Subsequently, Jacob et al. and Anderson et al. modified the Stoppa and iliac surgical window into the anterior intrapelvic or modified Stoppa approach to manage acetabular fractures [9,10].

The ilioinguinal and the modified Stoppa approaches are commonly used to fix fracture patterns that require anterior access to the anterior column, associated both columns, anterior column posterior hémi-transverse, transverse, and T-type fractures [5,9]. With the mechanical advantage in reducing and fixing fractures which are medially displaced, the modified Stoppa technique is a good substitute for the ilioinguinal technique in the treatment of anterior acetabulum fractures [11].

Many studies over the years have compared the two approaches, however a majority of the evaluations have not been conducted on any controlled trials (RCT) [[12], [13], [14], [15]]. To add to the pool of knowledge, we conceptualized a randomized prospective study to compare the ilioinguinal and the Stoppa approach based on functional outcomes, complication rates, reduction quality obtained, operative time and intra operative blood loss.