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Anatomical considerations of the internal iliac artery in association with the ilioinguinal approach for anterior acetabular fracture fixation


Karkare, N; Yeasting, R A; Ebraheim, N A; Espinosa, N; Scheyerer, M J; Werner, C M L (2011). Anatomical considerations of the internal iliac artery in association with the ilioinguinal approach for anterior acetabular fracture fixation. Archives of Orthopaedic and Trauma Surgery, 131(2):235-239.

Abstract

INTRODUCTION: Vascular injury may be encountered during an anterior approach to the pelvis or acetabulum-be it due to hematoma decompression, clot dislodgement during fracture manipulation, or iatrogenic. This can be associated with significant bleeding, hemodynamic instability, and subsequent morbidity. If the exact source of bleeding cannot be easily identified, compression of the internal iliac artery may be a lifesaving procedure. MATERIALS AND METHODS: We describe an extension of the lateral window of the ilioinguinal (or Olerud) approach elaborated on cadavers. RESULTS: The approach allows emergent access the internal iliac artery and intraoperative cross-clamping of the internal iliac vessels to control bleeding. CONCLUSION: The approach allows rapid access to the internal iliac artery. The surgeon should be familiar, however, with the surgical anatomy of this region to avoid potential injury to the ureter, peritoneum, lymphatics, and sympathetic nerves overlying the vessels when using the approach described.

INTRODUCTION: Vascular injury may be encountered during an anterior approach to the pelvis or acetabulum-be it due to hematoma decompression, clot dislodgement during fracture manipulation, or iatrogenic. This can be associated with significant bleeding, hemodynamic instability, and subsequent morbidity. If the exact source of bleeding cannot be easily identified, compression of the internal iliac artery may be a lifesaving procedure. MATERIALS AND METHODS: We describe an extension of the lateral window of the ilioinguinal (or Olerud) approach elaborated on cadavers. RESULTS: The approach allows emergent access the internal iliac artery and intraoperative cross-clamping of the internal iliac vessels to control bleeding. CONCLUSION: The approach allows rapid access to the internal iliac artery. The surgeon should be familiar, however, with the surgical anatomy of this region to avoid potential injury to the ureter, peritoneum, lymphatics, and sympathetic nerves overlying the vessels when using the approach described.

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Additional indexing

Contributors:Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, OH, USA.
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:28 Jan 2011 15:52
Last Modified:05 Apr 2016 14:39
Publisher:Springer
ISSN:0936-8051
Publisher DOI:10.1007/s00402-010-1143-y
PubMed ID:20585791

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