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Abstract
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OBJECTIVES: Complex acetabular fractures involving the quadrilateral plate may necessitate infrapectineal buttress plating, which can be performed through the pararectus approach. The aim of this cadaveric study was to identify the anatomical guide points to protect neurovascular structures at risk of injury during the pararectus approach.
METHODS: Six fresh frozen cadavers (12 hemipelves) were dissected in this study. Location of the inferior epigastric artery (IEA), obturator nerve (ON), and corona mortis (CM) was measured using common anatomic landmarks, namely anterior superior iliac spine (ASIS), symphysis pubis (SP), and sacroiliac (SI) joint.
RESULTS: In the superficial dissection of the abdominal wall, the mean distance between the IEA and ASIS was 106.7±5.2 (range, 99.2 to 116.4) mm, and the mean distance between IEA and SP was 77.9±3.5 (range, 70.6 to 82.2) mm. In deep dissection, the mean distance between the SI joint to the SP was 133.1±5.7 (range, 126.0 to 142.0) mm. The mean distance between the SI joint and ON was 37.3±2.8 (range, 31.0 to 41.0) mm. The CM was unable to be detected in two cadavers, one on the right and one on the left hemipelvis. The mean distance between the CM and SP was 47.7±3.9 (range, 43.0 to 55.0) mm.
CONCLUSIONS: A pararectus approach is a useful approach which allows infrapectineal plating in the treatment of complex acetabular fractures; however, the preservation of critical neurovascular structures is essential during dissection. This study is helpful to identify the structures at risk according to commonly used anatomic landmarks. These data might be a necessary guideline for hip and trauma surgeons.
Language: en |