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Standard Approaches to the Acetabulum Part 3: Intrapelvic Approach

Standardní přístupy k acetabulu. Část 3: intrapelvický přístup
Authors: A, Gänsslen; S, Grechenig; M, Nerlich; M, Müller; W, Grechenig; J, Lindahl;

Standard Approaches to the Acetabulum Part 3: Intrapelvic Approach

Abstract

Introduction The intrapelvic approach was originally described by Hirvensalo et al. from Finland in the early 90ies (8) and a further comparable description was published shortly thereafter by Cole et al. (5). Since then, various modifications have been described. Whereas the ilioinguinal approach was used until then to treat acetabular fractures with relevant anterior column involvement from an extrapelvic view, the intrapelvic approach was developed to address the often accompanied central hip dislocation in these fracture types with relevant fractures of the quadrilateral surface. With this approach a complete different view to the antero-medial acetabular pathology was possible. The view from more medial allows a better direct access to joint structures "below" the pelvic brim in the true pelvis (intrapelvic) in contrast to the extrapelvic access with the ilioinguibnal approach. Meanwhile, the surgical technique has been described in detail and some modifications and tricks have been published (5, 8, 10, 13, 19). The intrapelvic approach offers several advantages compared to the ilioinguinal approach: • lower invasiveness without substantial muscle detachment, • direct view of the superior pubic rami from superior and medial, the inferior anterior column and the quadrilateral surface up to the posterior border of the posterior column at the greater sciatic notch, • reduction and fixation of the anterior column and the quadrilateral surface under direct visualization, • reduction of antero-superior marginal impactions under direct visualization, • low risk of heterotopic ossification, • low risk of lesions to the lateral cutaneous femoral nerve. The aim of the third part of "standard approaches of the acetabulum" is to report on the special topics indication, positioning, exposure, incision, dissection, the anatomical basis of osteosynthesis and present results using the via the intrapelvic approach.

Keywords

Male, Fracture Fixation, Internal, Fractures, Bone, Treatment Outcome, Acetabuloplasty, Humans, Acetabulum, Female

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Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Average
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