Anterior pelvic subcutaneous internal fixator application: an anatomic study

Journal of Orthopaedic Trauma
Caroline MoazzamPeter A Cole

Abstract

To determine what anatomic structures are at risk after the application of a subcutaneous anterior pelvic internal fixator (APIF), from an incision over the anterior iliac crest to an incision centered over the pubic symphysis (Pfannenstiel). A laboratory investigation was performed using 5 fresh, frozen, nonpreserved cadaveric specimens (3 male specimens, 2 female specimens). Dissections were carried out to identify the relationships and proximity between the fixator screw constructs and various anatomic structures, including the (1) lateral femoral cutaneous nerve (LFCN), (2) ilioinguinal nerve (IIN), (3) iliohypogastric nerve (IHN), (4) femoral nerve, (5) femoral artery, (6) femoral vein, (7) genitofemoral nerve; and (8) spermatic cord or round ligament. The mean and range of distance from each of these structures to the implant were measured with calipers. Despite variations in pelvic anatomy and width of pelvic brims, precontoured fixators (3.5 locking reconstruction plates) did not violate any pelvic neurovascular structures using this recommended application of an APIF. The spermatic cord was easily avoided as they were directly visualized using our application technique (mean, 0.4 cm, range, 0-2 cm). Abdominal musculatu...Continue Reading

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Citations

Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·E McdonaldM Pekmezci
Oct 16, 2015·Injury·Peter A ColeJeffrey A Gilbertson
Aug 7, 2016·Case Reports in Orthopedics·Rahul VaidyaLawrence N Diebel
Jul 1, 2017·The Journal of International Medical Research·Xiao-Tian WuShan Zhao
Aug 8, 2015·Geriatric Orthopaedic Surgery & Rehabilitation·Timothy J O'Connor, Peter A Cole
Jul 12, 2017·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Ali Turgay ÇavuşoğluTeyfik Demir
May 31, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Shenglong DingXiaotian Wu
Oct 3, 2019·The Journal of Bone and Joint Surgery. American Volume·Martin C JordanRainer H Meffert
Jul 12, 2017·JBJS Essential Surgical Techniques·Peter A ColeEvgeny Dyskin
Apr 12, 2012·Clinical Orthopaedics and Related Research·Timothy G HiestermanPeter A Cole
Aug 11, 2018·Journal of Orthopaedic Trauma·Geoffrey S Marecek, John A Scolaro
Jul 1, 2017·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Theodoros H TosounidisPeter V Giannoudis
Feb 27, 2017·International Orthopaedics·Christian FangHans-Christophe Pape

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