关键词: 腹直肌外侧切口, 手术入路, 髋臼骨折, 死亡冠

Abstract:

Objective   To discuss the safety and clinical value of lateral-rectus approach in the treatment of acetabular fractures.   Methods   5 fresh adult cadaveric specimens (3 males,2 females) were used. For each cadaver, an dissection was conducted on the right side of the abdominal wall to be acquainted with the anatomy. While on the contralateral side the lateral-rectus approach was used to simulate the surgical  procedure to expose the pelvic ring. Anatomical observation and measurement of the anatomic indexes of the CMOR were performed.  Results   (1) An adequate exposure included the pelvic ring from the pubic symphysis to sacroiliac joints, quadrilateral plate, ala of ilium and most part of the medial side of the posterior column of acetabular is obtained by the lateral-rectus approach. (2)According to the anatomic observation and statistical analysis we found that the occurrence rate of the CMOR was 80% (8 sides), the average diameter of the CMOR was (2.1±1.9) mm, the average length was (4.7±0.5) cm. The average distance between the public symphysis and CMOR was (4.9±0.4) cm. And there was no significant difference between male and female. Conclusions   The lateral-rectus approach for fracture of acetabulum provides an adequate exposure of the most part of the pelvic ring including the sacroiliac joints under the condition of zero harm to vital nerves and blood vessels. Particularly, it’s more convenient for us to display and ligate ‘CMOR vessels’, compared with traditional approaches, it has evident edge for a better exposure of quadrilateral plate and posterior column of the acetabum, which has great potential clinical application value for the treatment of the acetabular fracture.

Key words: Lateral-rectus approach, exposure, Acetabular fracture, CMOR