Pelvic osteotomies: anatomic pitfalls at the ischium. A cadaver study.
Pelvic osteotomies for acetabular dysplasia include an osteotomy of the ischium. The potential anatomical hazards of three different osteotomies of the ischium were assessed by performing a triple osteotomy in a series of 8 fresh cadaver pelvises. An oblique osteotomy above the sacrospinous ligament using a posterior approach requires that the inferior gluteal and pudendal neurovascular bundles be mobilised and retracted. A transverse osteotomy below the sacrospinous ligament using a posterior approach can be performed in a relatively safe area between the pudendal and sciatic nerves. A transverse osteotomy from anterior can be performed through a modified Smith Peterson approach. The pudendal nerve medially, the sciatic nerve laterally and the medial circumflex artery distally are not visualised and are prone to damage.
de Kleuver
M
M
Department of Orthopaedic Surgery, St. Maartenskliniek, Nijmegen, The Netherlands.
Kooijman
M A
MA
Kauer
J M
JM
Kooijman
H M
HM
Alferink
C
C
D002102:Cadaver; D004210:Dissection; D006618:Hip Dislocation, Congenital / Q000601:surgery; D006801:Humans; D007512:Ischium / Q000033:anatomy & histology* / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010388:Pelvis / Q000033:anatomy & histology / Q000601:surgery; D012680:Sensitivity and Specificity