TOTBİD Dergisi

TOTBİD Dergisi

2011, Cilt 10, Sayı, 1     (Sayfalar: 025-031)

Intrapelvic approaches in pelvic and acetabular surgery

Halil İbrahim Açar 1, Murat Bozkurt 2, Doğan Atlıhan 3

1 Ankara Üniversitesi Tıp Fakültesi, Anatomi Anabilim Dalı, Ankara
2 Etlik İhtisas Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara
3 Derince Eğitim Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Kocaeli

Görüntüleme: 799
İndirme : 525

The aim in the treatment of pelvic and acetabular fractures is to obtain anatomic reduction and stable fixation. In order to reach this aim, it is necessary to provide enough field of vision to manage the field of fracture and to use the surgical tools easily. Intrapelvic approaches provide enough exposure of the pelvic brim. Ilioinguinal approach, which is one of these intrapelvic approaches, is a suitable approach for all anterior fractures that have anterior wall and anterior column extensions together with posterior hemitransverse extensions. This approach is not suitable for the reduction and stabilization of fractures of posterior wall and column. Modified Stoppa approach, first described in 1993 by Hirvensalo, provides the exposure of the pelvis from medial by a mid-line incision. With this approach, reaching posterior column and quadrilateral surface easily and instrumentation is possible. This approach has also important advantages like protection of inguinal ligament and canal and lateral cutaneous femoral and femoral nerves and a lower rate of external iliac vessel damage. When correctly planned and perfomed, it is possible to reach symphysis pubis, corpus pubis, ramus superior ossis pubis, iliac bone above and below the pectineal line, quadrilateral surface, medial surface of the posterior column, inc. ischiadica and sacroiliac joint easily by using this approach.

Anahtar Kelimeler : Acetabulum; ilioinguinal approach; modified Stoppa approach; pelvis; surgery