A new modified pararectus approach and visualization: an anatomical study


Atlihan D., Aydin M., Capkin S., Surucu S., Gunaydin F., AÇAR H. İ.

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, cilt.143, sa.5, ss.2493-2501, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 143 Sayı: 5
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s00402-022-04478-2
  • Dergi Adı: ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE, SportDiscus
  • Sayfa Sayıları: ss.2493-2501
  • Anahtar Kelimeler: Cadaver, Pararectus approach, Pelvic fractures, Stoppa approach, ACETABULAR FRACTURES, STOPPA APPROACH, CORONA MORTIS, ANTERIOR, FIXATION, EXPOSURES, COMPLEX
  • Ankara Üniversitesi Adresli: Evet

Özet

Introduction The aim of our study was to visualize all the windows used in the pararectus approach with detailed cadaver images to facilitate better understanding of orthopedic surgeons and, in addition, was to modify the incision used in the pararectus approach to a more cosmetic bikini incision. Materials and methods In total, 20 cadavers fixed in 10% formalin were used in this study. Of these cadavers, 14 were male and six were female, with a mean age at death of 57 (42-82 years). The four windows were defined as follows in all the cadavers: pubic, quadrilateral, sacroiliac, and iliac windows. Results The most important structure at risk in the pubic window was the corona mortis, as it was observed in 12 (60%) cadavers. In men, the spermatic cord was an important structure at risk in the pubic window. The obturator vessels and nerves were the structures at most risk in the quadrilateral window due to their close location with the quadrilateral surface. The obturator nerve on the medial side and at the entrance of the pelvis through the linea terminalis and lumbosacral truncus were the structures at most risk close to the sacroiliac joint in the sacroiliac window. Conclusion This anatomical study includes highly instructive visual shapes and cadaver images for the acetabulum and pelvis, whose anatomical structures are quite complex. We have found that this modified pararectus approach provides excellent access to the internal pelvic rim.