Retropubic vascular hazards of the ilioinguinal exposure: a cadaveric and clinical study.
In the course of ilioinguinal exposure, significant bleeding can occur from anastomotic vascular channels along the posterior aspect of the superior public ramus. A cadaveric study was undertaken to quantify and qualify these communicating vascular systems. We made bilateral ilioinguinal exposures on 40 cadavers. All vessels > 2 mm in diameter, connecting the obturator system with a more superficial system, were singled out and their courses recorded. Fifty-eight of 79 sides (73%) had at least one large-diameter communicating vascular channel along the posterior aspect of the superior pubic ramus. In 47 of the 79 exposures (59%) communicating veins were noted. Arterial channels were identified in 34 exposures (43%). A prospective clinical study was also performed. Thirty-eight consecutive patients with displaced acetabular fractures were treated surgically using ilioinguinal exposures. Fourteen of the patients (37%) had anastomotic vessels. This study confirms the variability of the retropubic vascular system.
Teague
D C
DC
Harborview Medical Center, University of Washington, Department of Orthopaedic Surgery, Seattle, USA.
Graney
D O
DO
Routt
M L
ML
D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006119:Groin / Q000098:blood supply*; D006615:Hip / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies