title: Modified ilioinguinal approach to the acetabulum and pelvis from beneath the inguinal ligament: a subinguinal approach.
abstract: The ilioinguinal approach is favoured for fractures of the anterior part of the pelvis, but it is associated with some technical difficulties and it is not suitable for some complex fractures. In 2008, a modified ilioinguinal approach was introduced by Farid Yr which afforded visualisation of the inside and outside of the pelvis. The approach involves retroperitoneal access below the inguinal ligament to preserve the integrity of the inguinal canal and allows exposure of anterior and medial wall fractures as well as the anterior hip capsule. Despite the dimensions of the procedure, closure is anatomical because repair of the inguinal canal floor is not required. We report the use of this approach in 17 patients with T-type fractures of the acetabulum, transverse fractures of acetabulum, Tile C1 pelvic fractures, malunion of the pelvis and acetabular dysplasia. The approach is recommended in complex cases of acetabular surgery (including obese or muscular patients) and complicated or old fractures in which a better exposure is required. It is useful in visualisation of the anterior wall and labrum and intra articular structures, and in viewing the internal anatomy of the pelvis and acetabulum. It may be a suitable approach for periacetabular osteotomy.
authors.affiliation: Department of Orthopaedic Surgery, Akhtar Orthopaedic Research Center, Akhtar Orthopaedic Hospital, Shahid Beheshti Medical University (SBMU), Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Seyyed Hosseinzadeh
authors.forename: Alireza
authors.initials: A
authors.lastname: Eajazi
authors.forename: Mehrnoush
authors.initials: M
authors.lastname: Hassas Yeganeh
authors.forename: Laleh
authors.initials: L
authors.lastname: Daftari Besheli
authors.forename: Seyyed Morteza
authors.initials: SM
authors.lastname: Kazemi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Bigdeli
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Okhovvatpoor
mesh_terms: D000077:Acetabulum / Q000293:injuries / Q000601:surgery*; D000328:Adult; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries / Q000601:surgery*; D055815:Young Adult