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Anatomy and modification of the middle window in the subilioinguinal approach
XU Shun-li ZHAO Xue-song Lü Xiang WANG Yi-sheng*
Acta Anatomica Sinica ›› 2014, Vol. 45 ›› Issue (6) : 819-823.
Anatomy and modification of the middle window in the subilioinguinal approach
Objective To provide the anatomical evidence to prevent vascular damage and lyphatical leakage during the subilioinguinal approach for acetabulum fracture. Methods Twenty human adult cadavers were dissected in the Anatomy Department of Xinxiang Medical University.The structures associated with the middle window of the subilioinguinal approach were observed. Results Inferior epigastric artery was derived from external iliac artery (57.5%) or femoral artery(17.5%), was (41.35±2.33)mm from pubic symphysis，and had a (40.23±5.23)° angle with external iliac artery.There was no difference between left and right sides,and no correlation with the width and length of pelvis. There was no fascia-like structure around the iliac blood vesses. The fascia-like structure was observed around the femoral blood vessels but it was easy to be separated from the surrounding structures. The angle between the origin of iliopectineal arch and the medial end of the inguinal ligament was sharp and at (15.20±6.79)°and filled by a thin membrane-like structure. The medial and inferior part of the iliac fascia was thick and had no correlation with the width and length of pelvis. Conclusion Blood vessel and lymphatic vessel are prone to injury in the subinguinal and inguinal approaches. Inferior part of iliac fascia and iliopectineal arch are compact, and thus the lateral window may pass through medially under the fascia iliaca.
Sub-ilioinguinal approach / Iliac fascia / Applied anatomy / Human
［1］Letournel E. Acetabular fracture:classification and management［J］.Clin Oerhop, 1980,(151):86-106.
［2］Lefaivre KA, Starr AJ, Reinert CM. Modified anterior exposure to the acetabulum for treatment of difficult anterior acetabular fractures［J］.J Orthop Trauma, 2009, 23(5):370-378.
［3］Farid YR.The subinguinal retroperitoneal approach for fractures of the acetabulum: a modified ilioinguinal approach［J］.J Orthop Trauma,2008,22(4): 270-275.
［4］Probe R,Reeve R,Lindsey RW.Femoral artery thrombosis after open reduction of an acetabular fracture［J］. Clin Orthop Relat Res,1992,（283）:258-260.
［5］Gu HL,Duan JZh,Wang H.Risk factors for deep vein thrombosis after operations for acetabular fractures［J］.Chinese Journal of Bone and Joint Injury,2007,22(6）：462-464. (in Chinese)
顾海伦,段景柱,王欢.髋臼骨折术后下肢深静脉血栓形成的多因素分析［J］.中国骨与关节损伤杂志,2007,22（6）：462-464.
［6］Wang L, Zhen XZh, Yang YT, et al. Preliminary report of lymphatic fistula in ilioinguinal approach for acetabular fracture［J］.Journal of Practical Orthopaedics,2009，15(7):522-523. (in Chinese)
王亮，甄相周，杨彦亭,等.髋臼骨折髂腹股沟人路并发淋巴瘘初步的报告［J］.实用骨科杂志,2009,15(7):522-523.
［7］Xu ZhY, Ren YH, Tu LL, et al.Anatomy of the femoral fascia sheath and its adjacent structures［J］.Acta Anatomica Sinica,2013,44(3):364-367. (in Chinese)
徐朝阳，任彦红,涂丽莉,等. 股神经周围筋膜及其毗邻结构的解剖［J］.解剖学报,2013,44(3):364-367.
［8］Ruchholtz S, Taeger G, Zettl R.A novel two-incision minimally invasive method for the treatment of anterior acetabular fractures［J］. Der Unfallchirurg, 2013, 116(3):277-282.
［9］Zu G, Bi DW, Zheng Q, et al.Anatomy and clinics of the retrograde acetabulum anterior column screw percutaneously［J］.Acta Anatomica Sinica, 2011, 42(5): 649-652. (in Chinese)
祖罡，毕大卫,郑琦,等.经皮逆行髋臼前柱螺钉的应用解剖与临床［J］. 解剖学报,2011,42(5):649-652.
［10］Bai DF, Chen HL, Huo MZh, et al. Application of two windows ilioinguinal approach and acetabular anatomic plate in treatment of acetabular fractures［J］.China Medical Herald, 2013,10(14):156-158. (in Chinese)
白大峰,陈洪亮,霍明哲,等.应用两窗髂腹股沟入路治疗髋臼骨折的效果观察［J］.中国医药导报,2013,10(14):156-158.
［11］Xue ZCh,An ZhQ.Reduction and internal fixation of anterior acetabular fractures via modified two-window ilioinguinal approaches［J］. Chinese Journal of Orthopaedic Trauma,2013,15(8):680-684. (in Chinese)
薛子超,安智全.经改良的双窗髂腹股沟入路治疗髋臼前部骨折［J］.中华创伤骨科杂志,2013,15(8):680-684.
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