Is the obturator artery safe when performing ischial osteotomy during periacetabular osteotomy?

Kamada, Shin; Naito, Masatoshi; Shiramizu, Kei; Nakamura, Yoshinari; Kinoshita, Koichi

doi:10.1007/s00264-010-1064-y

Cited by 14 publications

(4 citation statements)

References 12 publications

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“…presented that the mean distance between the obturator artery and the ischial osteotomy site was 35.6 ± 7.5 mm and always exceeded 20 mm. 13 Furthermore, we realized that the obturator artery was under risk at the proximal of quadrilateral posterior osteotomy more so than in ischial osteotomy. In our study, we used an image intensifier to locate the ischial osteotomy.…”

Section: Discussionmentioning

confidence: 99%

A Minimally Invasive Technique Using a Modified Stoppa Approach for Periacetabular Osteotomy: A Preliminary Cadaveric Study

Akgül

Coşkun

Korkmaz

et al. 2017

IJOO

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Background:Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO).Materials and Methods:Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically.Results:The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min–28° max) preoperatively to 44.1° ± 3.7 (range 36° min–48° max). The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min–26 mm max). The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm–21 mm) and lateral displacement was 20.3 ± 3.23 mm (range 15 mm–24 mm). The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm.Conclusion:This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy.

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Section: Discussionmentioning

confidence: 99%

A Minimally Invasive Technique Using a Modified Stoppa Approach for Periacetabular Osteotomy: A Preliminary Cadaveric Study

Akgül

Coşkun

Korkmaz

et al. 2017

IJOO

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“…During ischial osteotomies, the OA and CM can be injured due to a difficulty of visualization during an anterior approach (Kamada et al, 2011;Wada et al). Different approaches of osteotomies possess different risks of iatrogenic injury since the structures involved are different.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Implications of the Corona Mortis: A Case Report

Babinski

Gonçalves²,

Ramallo

et al. 2018

Int. J. Morphol.

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SUMMARY:Corona mortis is classified as a connection between the inferior epigastric and obturator vessels over the superior pubic ramus. Its incidence varies among different studies. The corona mortis is an extremely important anatomical variation as it can be injured in a great number of procedures. Moreover, it can also be injured during pelvic or acetabular fractures. A male cadaver fixed in a 10 % formalin solution had its pelvic region dissected and an arterial corona mortis was observed on its right side. The left hemipelvis presented no variations whatsoever. This vessel was measured with the aid of a digital caliper. We aim to report this variation and address -from an orthopedic point of view -the clinical and surgical significance of the corona mortis.

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“…Care is taken not to stray medially as the obturator neuromuscular bundle is close as it exits the inner pelvis underneath the obturator canal and pierces the obturator membrane. In a study of 29 cadaveric hemipelvises, the distance between the inferior ischial osteotomy site and the obturator artery has been shown to be an average of 36mm with a minimum of 22 mm [9]. It is also important to not dissect distal to the cephalad margin of the obturator externus in order to not jeopardize the medial femoral circumflex artery which constitutes the main blood supply to the femoral head [10].…”

Section: Deep Dissectionmentioning

confidence: 98%

Surgical Approach for Periacetabular Osteotomy

Zlowodzki

Virkus

2013

Hip Arthroscopy and Hip Joint Preservation Surgery

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The surgical technique for the Bernese periacetabular osteotomy was developed by Prof. Reinhold Ganz in 1984 for the treatment of hip dysplasia (Ganz R, Klaue K, Vinh TS, Mast JW. Clin Orthop Rel Res 232: [26][27][28][29][30][31][32][33][34][35][36] 1988). The purpose of the surgical approach is to expose the innominate bone in order to enable an osteotomy which allows for a complete detachment of the acetabulum while leaving the posterior 50 % of the posterior column intact. The dissection resembles the well-known Smith-Petersen approach with a few modifications. Anatomical structures at risk during surgical exposure and osteotomy include the lateral femoral cutaneous nerve, the femoral nerve, the sciatic nerve, the obturator artery and nerve, and the medial femoral circumflex artery. This chapter describes in detail the surgical setup, the planes of dissection, the location of the neurovascular structure at risk, and how to avoid complications.

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Is the obturator artery safe when performing ischial osteotomy during periacetabular osteotomy?

Cited by 14 publications

References 12 publications

A Minimally Invasive Technique Using a Modified Stoppa Approach for Periacetabular Osteotomy: A Preliminary Cadaveric Study

A Minimally Invasive Technique Using a Modified Stoppa Approach for Periacetabular Osteotomy: A Preliminary Cadaveric Study

Orthopedic Implications of the Corona Mortis: A Case Report

Surgical Approach for Periacetabular Osteotomy

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