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


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.


CONCLUSIONS
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.
Karkare
Nakul
N
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
Yeasting
Richard A
RA
Ebraheim
Nabil A
NA
Espinosa
Norman
N
Scheyerer
Max J
MJ
Werner
Clément M L
CM
D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged