Objective To validate the safety and feasibility of the modified pararectus abdominis approach in the treatment of posterior pelvic ring injury and contralateral anterior ring injury in one incision through anatomical experimentation. Methods Three specimens of cadaver were collected. A modified pararectus abdominis approach with a single incision was used to expose the ipsilateral anterior and posterior pelvic rings and extend to the contralateral anterior pelvic ring. The safety and efficacy of this method was evaluated by assessing the extent of exposure and potential risks to adjacent structures, such as the iliac vessels and corona mortis in the contralateral side, examining the structures exposed, simulating fixation, and collecting relevant data and images. Results The ipsilateral exposure range: This approach extended medially to the midline of the abdomen, reached posteriorly the contralateral edge of the S1 vertebral body, while anteriorly extended to the L5 vertebral body, while it reached the S1 foramen in the true pelvis when exposing caudally. The contralateral exposure range: the contralateral side of the incision could be accessed until reaching the opposite iliopubic eminence. Heading towards the quadrilateral area of acetabulum could expose the medial surface of the contralateral anterior upper part of it, and the depth of the approach extended to upper lateral half of the inner surface of the obturator formamen. Furthermore, the modified approach was effective in revealing the ipsilateral sacroiliac joint and the contralateral pubic ramus while treating the injury of the ipsilateral posterior and contralateral anterior rings under direct visualization. The total incision length was measured at (7.84±0.18) cm, and the distances from the pubic symphysis to the contralateral corona mortis and anterior superior iliac spine recorded as (57.07±1.04) cm and (67.43±0.87) cm, respectively. Conclusions The use of modified pararectus abdominis approach for treating ipsilateral posterior pelvic ring injury and contralateral anterior pelvic ring injury through one incision is a safe and an effective minimally invasive surgical technique that offers advantages in terms of visualization.
Key words
Modified pararectus abdominis incision; /
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Anatomy; /
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Local; /
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Pubic ramus; /
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Anterior approach
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